media response paper 5

media response paper 5

For Alya, who grew up without a TV set, and Max and Katya, who never answer my phone calls but will always text me back. —VCS

For my three children, David, Adam, and Julia, who are always with me—in my head, in my heart, in my teaching, and in my research—

even when they are not physically present. —ABJ

To my very social teenage daughters, Isabel and Grace, who continue to inspire my work and who have taught me a lot about texting, tweeting, Facebook, and Instagram. And to my husband,

John, who ensures we have healthy family meals during which cell phones are not allowed. —BJW



Copyright © 2014 by SAGE Publications, Inc.

All rights reserved. No part of this book may be reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without permission in writing from the publisher.

Printed in the United States of America

Library of Congress Cataloging-in-Publication Data

Strasburger, Victor C., 1949-

Children, adolescents, and the media / Victor C. Strasburger, University of New Mexico School of Medicine, Barbara J. Wilson, Department of Communication at the University of Illinois at Urbana-Champaign, Amy B. Jordan. — Third Edition.

pages cm Includes bibliographical references and index.

ISBN 978-1-4129-9926-7 (pbk. : alk. paper)

1. Mass media and children—United States. 2. Mass media and teenagers—United States. I. Wilson, Barbara J. II. Jordan, Amy B. (Amy Beth) III. Title.

HQ784.M3S78 2013 302.23083—dc23 2012046292

This book is printed on acid-free paper.

13 14 15 16 17 10 9 8 7 6 5 4 3 2 1



SAGE Publications, Inc. 2455 Teller Road Thousand Oaks, California 91320 E-mail:

SAGE Publications Ltd. 1 Oliver’s Yard 55 City Road London EC1Y 1SP United Kingdom

SAGE Publications India Pvt. Ltd. B 1/I 1 Mohan Cooperative Industrial Area Mathura Road, New Delhi 110 044 India

SAGE Publications Asia-Pacific Pte. Ltd. 3 Church Street #10-04 Samsung Hub Singapore 049483

Acquisitions Editor: Reid Hester Assistant Editor: Eve Oettinger Editorial Assistant: Sarita Sarak Production Editor: Brittany Bauhaus Copy Editor: Rachel Keith Typesetter: C&M Digitals (P) Ltd. Proofreader: Joyce Li Indexer: Kathy Paparchontis Cover Designer: Bryan Fishman Marketing Manager: Lisa Sheldon Brown Permissions Editor: Adele Hutchinson


Brief Contents

Preface Acknowledgments

Chapter 1: Children and Adolescents: Unique Audiences

Chapter 2: Advertising

Chapter 3: Prosocial and Educational Media

Chapter 4: Media Violence

Chapter 5: Sex, Sexuality, and the Media

Chapter 6: Drugs and the Media

Chapter 7: Obesity, Eating Disorders, and the Media

Chapter 8: The Internet

Chapter 9: Social Media

Chapter 10: Video Games

Chapter 11: Family and Media

Chapter 12: Media Literacy/Media Education

Chapter 13: Children’s Media Policy

Author Index

Subject Index

About the Authors

About the Contributors


Detailed Contents

Preface Acknowledgments

Chapter 1: Children and Adolescents: Unique Audiences The Media Environment and Habits of Today’s Youth Children Are Different From Adults Children Are Different From Each Other Adolescents Are Different From Children Developmental Differences in Processing the Mass Media

Younger Children Versus Older Children From Perceptual to Conceptual Processing From Centration to Decentration From Perceived Appearance to Reality From Concrete to Inferential Thinking

Older Children Versus Adolescents From Real to Plausible From Empirical to Hypothetical Reasoning Metacognitive Thinking Regulatory Competence

Two Overall Developmental Trends Increase in Domain-Specific Knowledge Increase in Processing Capacity

Infants and Baby Media Conclusion Exercises References

Chapter 2: Advertising Historical Changes in Advertising to Children Content Analyses of Television Advertising Cognitive Processing of Advertising


Attention to Advertising Discrimination Between Ads and Programming Comprehension of Advertising

Understanding Selling Intent Recognition of Bias Comprehension of Disclaimers

The Persuasive Impact of Advertising Brand Loyalty Desire for Products Parent-Child Conflict Materialism and Value Orientations

Phases of Consumer Behavior During Childhood Marketing Strategies in the 21st Century

Character Merchandising Product Placement Viral Marketing Online Marketing to Youth Marketing in Schools

Teaching Advertising Literacy Conclusion Exercises References

Chapter 3: Prosocial and Educational Media Economic and Regulatory Forces That Affect Media Offerings for

Children Regulation Economics

Children’s Educational Learning From Media The Lessons of Sesame Street and Children’s Educational Media Media and Make-Believe Media and Language Learning Lasting Effects of Exposure to Educational Media When the Medium Is the Message

Children’s Social Learning From Media Prosocial Media Content for Children

Do Prosocial Media Affect Youth? The Research Evidence

Empathy Altruism/Helping


Social Interaction Acceptance of Others/Acceptance of Diversity

The Limitations of Research on Prosocial Content for Children Prosocial Media for Adolescents

Prosocial Messages and Outcomes in New Media Technologies

National and International Prosocial Efforts Opportunities Presented by New Media Technologies for

Children With Learning Differences Learning to Learn From Media Conclusion Exercises Notes References

Chapter 4: Media Violence How Violent Are American Media? Does Media Violence Attract Youth? Can Media Violence Lead to Aggression?

Experimental Studies Correlational Studies Longitudinal Studies Meta-analyses

Why Does Exposure to Violence Encourage Aggression? Cognitive Priming Social Learning Social Informational Processing Theory

Types of Portrayals That Encourage the Learning of Aggression Types of Youth Most at Risk Developmental Differences in Processing Media Violence Relational or Social Aggression Can Media Violence Desensitive Young People? Can Media Violence Produce Fear? Cultural Debates About Media Violence

Guns and the Media Suicide and the Media Japan Versus the United States: A Cross-Cultural Comparison

Can Media Violence Have Positive Effects? Conclusion Exercises



Chapter 5: Sex, Sexuality, and the Media Why Is This an Issue? Where’s the Sex?

Traditional Media Television Prime-Time TV Soap Operas Reality TV A Broader Definition of Sex Advertising Movies Print Media Music and Music Videos Music Music Videos

New Technology Social Networking Sexting Pornography

What the Research Says Correlational Studies Experimental Studies Longitudinal Studies

Why Teenagers May Be Particularly Susceptible to Sexual Content in the Media

Contraceptive Advertising Prosocial Sexual Content on Television Solutions Conclusion: Unanswered Questions Exercises References

Chapter 6: Drugs and the Media Adolescent Drug Use Determinants of Child and Adolescent Drug Use

Peers Family


Personality Biology

The Impact of Advertising on Children and Adolescents Cigarettes

The Impact of Cigarette Advertising Cigarettes in Television Programming, in Music and Music Videos,

in Movies, and on the Internet Alchohol

Research on Alcohol Advertising Alcohol on TV, in Music and Music Videos, in Movies, and Online

Illicit Drugs A Word About Prescription and Nonprescription Drugs Solutions Exercises References

Chapter 7: Obesity, Eating Disorders, and the Media Are the Media a Cause of Obesity in Children and Adolescents? The Role of Food Advertising and Marketing

Fast Food Junk Food The Prevalence of Advertising New Technology Food Advertised in Schools The Impact of Advertising

Food on TV and in Movies Do Media Displace Physical Activities? Media and Eating Behavior Media, Sleep, and Obesity The Impact of Media on Body Self-Image and Eating Disorders

Body Image in Media Teen Magazines Definitions of Beauty Disordered Body Image Research on Media and Body Self-Image A Sociocultural Theory Anorexia Nervosa and Bulimia New Media Conclusion



Obesity Eating Disorders Media Literacy

Exercises References

Chapter 8: The Internet Are Children and Adolescents Using the Internet?

The Technology Is Changing Fast Are Parents Concerned?

The Internet: What Is It? Concerns About the Internet

The Internet as a Medium for Media Violence Sex on the Net: A Primary Concern Viewing of Sexual Materials Advertising Food Products to Children: The Latest Concern Other Areas of Concern

Solutions to Internet Concerns Government Regulation Blocking Technology Child-Friendly Sites Media Literacy

On the Positive Side Conclusion Exercises References

Chapter 9: Social Media What Are Social Media? Social Media Sites Popular Among Teens Risks Associated With Social Media Use

Influence Displays of Health-Risk Behaviors on Social Media Cyberbullying Sexting Online Solicitation

Benefits of Social Media New Opportunities for Education and Prevention Connection and Social Capital


Civic and Political Engagement Academic Work

Conclusion Exercises References

Chapter 10: Video Games The Development of Video Games Time Commitment Why Are Video Games Popular? Game Ratings A Closer Look at Violent Video Games

The Appeal of Violent Video Games The Importance of a Preference for Violent Video Games An Integrative Theoretical Model Mechanisms Desensitization to Violence Evaluating Research on the Effects of Exposure to Violent Video

Games High-Risk Players and a Relative Risk Model

The Negative Impact of Gender Stereotypes Video Games and Health Risks

Physical Injury Seizures Cardiovascular Reactivity Obesity Attention Problems Adjustment Disorders Addiction

The Positive Potential of Video Games Skill Improvement Video Games in Education Games for Health

Exergames Brain Fitness Games Games for Coping With Medical Conditions Psychotherapy

Games for Change Public Policy and Practical Recommendations Conclusion


Exercises References

Chapter 11: Family and Media The Home as a Multimedia Environment

Television in the Bedroom Television Viewing During Mealtime The Constant TV Home

Socialization to Media Use Within the Family Context Parental Mediation of Children’s Media Use

Theoretical Perspectives Ecological (Systems) Theory Baumrind’s Taxonomy of Parenting Styles Family Communication Patterns Social Cognitive Theory

Reducing Screen Time in the Home Exercises References

Chapter 12: Media Literacy/Media Education Demands for Change Defining Media Literacy Defining Media Education Uses of Media Literacy Does Media Literacy Work? Reviewing the Literature Teaching Media Literacy Skills Media Literacy and Public Health

Tobacco, Alcohol, and Drugs The Importance of Emotion

Nutrition and Obesity Body Image

Media Education and Violence Responding to Sexual Portrayals Channel One: The Largest Media Literacy Experiment

Channel One’s Media Literacy Curriculum Teaching Media Literacy The Content of Media Literacy A Sample Deconstruction Media Literacy Production


Creating Counter-Ads Activism and Media Education Big Media: Part of the Solution? Parents, Media Literacy, and Corporate Funding Summary Exercises Notes References

Chapter 13: Children’s Media Policy Philosophy of Regulation U.S. Agencies

The Federal Trade Commission The Federal Communications Commission

Advocacy Groups Action for Children’s Television The Parents Television Council Campaign for a Commercial-Free Childhood The Center for Digital Democracy

Industry Self-Regulation Advertising Policy Privacy Policy Educational Media Policy Age-Inappropriate Movie and Video Game Marketing and Sales Indecency Ratings Policy

Movie Ratings TV Ratings Video Game Ratings

Moving Forward Consistency in Ratings Enforcement of Existing Rules Greater Funding of Beneficial Media Parent Education

Exercises References

Author Index

Subject Index


About the Authors

About the Contributors




merican youth spend the vast majority of their leisure time with the media. They laugh with television characters who are funny; they viciously attack and destroy evil videogame creatures; they see advertising for candy, makeup, and even liquor; they listen to rap lyrics about sex and violence; and they interact with people all

over the world online. The social world these “digital natives” experience is very different from the one their parents and grandparents faced during childhood.

The purpose of this book is to provide an overview of what is known about the impact of the media on youth in the 21st century. The goal is to provide a comprehensive, research-oriented treatment of how children and adolescents interact with the media and of the role it has assumed in their everyday lives. In each chapter, we review the latest findings as well as seminal studies that have helped frame the issues. Because research alone can often be dry and difficult to follow, we have sprinkled each chapter with illustrations, examples from the media, public debates, and real-life instances of media impact. Our intent is to show the relevance of social science research to media-related issues involving youth.

One of the unique features of this book is its developmental focus. In Chapter 1, we begin with a discussion of how children and teens are unique audiences of the media, and we outline developmental differences in how young people process and make sense of media content and form. We also discuss how babies increasingly are interacting with media. Our developmental framework is used throughout the remainder of the book to help readers appreciate how, for example, a 5-year-old might respond differently to a media message than a 10-year-old or a 15-year-old would. In subsequent chapters, we examine the impact of media content in distinct areas, including advertising (Chapter 2); educational and prosocial content (Chapter 3); violence (Chapter 4); sexuality (Chapter 5); drugs, alcohol, and tobacco (Chapter 6); obesity and eating disorders (Chapter 7); and the family (Chapter 11). An important strength of this book is the inclusion of


chapters written by leading experts in the topic, including Ed Donnerstein, who writes about revolutionary ways in which the Internet has changed the landscape of content available to children (Chapter 8); Megan Moreno, who presents cutting-edge research on youth engagement with social media (Chapter 9); and Jeanne Funk Brockmyer, who writes about the positive and negative outcomes of video game playing (Chapter 10). Finally, Robert McCannon has provided a thorough review of studies and a guide for media literacy and media education as a strategy for inoculating youth against the negative effects of antisocial content (Chapter 12). The book concludes with a consideration of U.S. media policies and their effectiveness at improving the media environment in which children live and learn.

Two other features make this book unique. First, the book covers the entire developmental period ranging from infancy to childhood to adolescence. Other media-related books have been limited to addressing only children or only teens, but to our knowledge, this is the first media book of its kind that deals with the entire age span that characterizes youth. Second, the three authors bring very different backgrounds to the issues at hand. Victor C. Strasburger is a Distinguished Professor of Pediatrics who has spent most of his career looking at the impact of the mass media on children’s health. Barbara J. Wilson is the Kathryn Lee Baynes Dallenbach Professor of Communication who conducts research on child development and the media. Amy B. Jordan is the Director of the Media and the Developing Child sector of the Annenberg Public Policy Center at the University of Pennsylvania, where she studies the impact of media policy on children and families. Together we have identified the media topics that are most pressing to parents, health care practitioners, educators, and policymakers today. As coauthors, we bring our rich and diverse experiences in medicine, social science, child development, and public policy to the issue of youth and media. We also all are parents, which of course gives us firsthand experience with many of the issues we raise.

The approach we have taken is grounded in the media effects tradition. Where appropriate, we have highlighted other perspectives and readings that take a more cultural or critical approach to the study of media and youth. Those perspectives sensitize us to the importance of considering children and teens as active and powerful agents of their media experiences. Youth cannot be shielded from the media, nor should they be. Clearly, children use the media to learn about their culture as well as about childhood itself. In fact, several chapters in this edition of our book focus exclusively on the positive effects of exposure to the media on children’s


development. Still, there is much we can do to help children and teens approach the media as critical consumers. Readers will notice that we have selected some of the most controversial topics about the media for several chapters of this book. Our aim is not to be one-sided but instead to target the areas at the heart of debates in the United States about the media and public health. Where relevant, we also introduce how other countries are grappling with these issues. We hope we have highlighted the importance of considering the content of the messages to which children are exposed. For today’s young people, there are tremendous benefits as well as serious hazards of spending time with media.

This book is designed to serve as a core text for courses in communication, psychology, education, and public health where content covers children and the media. It could also serve as supplemental reading in courses on child and adolescent development, issues in child development, or issues in the media. The book is most appropriate for an upper-level or advanced undergraduate course or even a beginning graduate seminar in the area. We assume some basic knowledge of research methods in social science, but we also provide background to help readers distinguish and compare different research traditions and methodologies. As a way to engage students, we provide a series of exercises at the end of each chapter. The exercises are meant to stimulate debate and can serve as paper assignments or small-group discussion activities. To our minds, the exercises illustrate just how complex and engaging the media environment is for today’s youth.



Dr. Strasburger would like to thank his colleagues in the Council of Communications of the American Academy of Pediatrics, who have supported his interest in the media, and his colleagues at the University of New Mexico School of Medicine, who have allowed him time to write this book. In particular, he would like to thank Dr. Loretta Cordova de Ortega, Chair of the Department of Pediatrics, and Dr. Paul Roth, Chancellor of the UNM Health Sciences Center.

Dr. Wilson would like to thank two industrious doctoral students, Julius M. Riles (MA, University of Illinois at Urbana-Champaign) and Kira Varava (MA, University of Illinois at Urbana-Champaign), for their persistent efforts to track down journal articles, online references, and terrific examples of media content popular with youth.

Dr. Jordan would like to thank Michael Delli Carpini, Dean of the Annenberg School for Communication, and Kathleen Hall Jamieson, Director of the Annenberg School for Communication, for their unfailing support in her teaching and research in the field of children, adolescents, and the media.

Victor C. Strasburger Barbara J. Wilson

Amy B. Jordan



Children and Adolescents Unique Audiences

Sometimes wise and disconcertingly like adults, children are nonetheless children. To the wonder, joy, and vexation of adults, they are different. As they grow older, they become increasingly like us and therefore intelligible to us, but at each age or stage of development there is something for adults to learn more about, to be amused by, and to adjust to.

—Professor Aimee Dorr Television and Children: A Special Medium for a Special

Audience (1986, p. 12)

Over the past twenty or thirty years, the status of childhood and our assumptions about it have become more and more unstable. The distinctions between children and other categories—“youth” or “adults”—have become ever more difficult to sustain.

—Professor David Buckingham After the Death of Childhood: Growing

Up in the Age of Electronic Media (2000, p. 77)

Children and young people are a distinctive and significant cultural grouping in their own right—a sizeable market share, a subculture even, and one which often “leads the way” in the use of new media.

—Professor Sonia Livingstone Young People and New Media: Childhood and the Changing Media Environment (2002, p. 3)

Unlike the children of the 1950s, 1960s, and 1970s, whose media choices were limited and stood out like isolated, familiar landmarks in communal life, kids today inhabit an environment saturated and shaped by a complex “mediascape” that envelops and bombards them day and night.



—James P. Steyer The Other Parent: The Inside Story of

Media’s Effect on Our Children (2002, p. 4)

ecause it was one of her favorite movies, Louise decided to rent a DVD of the film Monsters, Inc. to share with her two children, a 4- year-old and a 10-year-old. The 10-year-old immediately liked the blue-furred Sulley and his one-eyed sidekick Mike, laughing at the monsters as they scared children and collected their screams to

power their factory in the city of Monstropolis. The 4-year-old, on the other hand, tensed up the first time she saw Sulley’s hulking frame and Mike’s bulging eyeball. The young child asked several nervous questions: “What are they?” “Why are they trying to scare those kids?” Shortly thereafter, the 4-year-old announced that she did not like this “show” and that she wanted to change the channel. When a young girl named Boo accidentally entered the factory, the 4-year-old let out a yelp and buried her face in her blanket (see Figure 1.1). Louise was dismayed at her young child’s reaction, wondering how anyone could be frightened by such funny and benign monsters.

Although this example involves a fictitious family, the incident is likely to resonate with parents who are often perplexed by their children’s responses to the media. Indeed, a great many parents have reported that their preschool children were unexpectedly frightened by the gentle but strange-looking alien in the movie E.T. the Extra-Terrestrial (Cantor, 1998). Likewise, G- rated movies such as Bambi and Beauty and the Beast have provoked fear in younger children (Hoekstra, Harris, & Helmick, 1999). One study even found that younger children were frightened by Michael Jackson’s music video “Thriller,” which featured the popular singer transforming into a werewolf (Sparks, 1986).

Figure 1.1 Image from the film Monsters, Inc.


These reactions are not unique to a few films or videos. Research has documented strong differences in the types of media themes that frighten people across age (Harrison & Cantor, 1999). The types of stories that most often upset children younger than 7 involve animals or distorted-looking characters such as ghosts and witches (see Figure 1.2). The impact of such themes greatly diminishes by the time people reach adolescence and adulthood. In older viewers, portrayals involving blood and physical injury are most likely to trigger negative emotions.

From an adult perspective, a young child’s fears of monsters and ghosts are difficult to explain. But they signal the importance of considering children’s unique orientation to the world in trying to understand how the media can affect younger audiences. In this chapter, we will explore how children and adolescents interact with the media, concentrating on the crucial role human development plays in the process. As background, we will first give an overview of the media environment and media habits of today’s youth. Next, we will explore several major principles or ideas that can be gleaned from child development research: Children are different from adults, children are different from each other, and adolescents are different from children. We will conclude the chapter with a focused look at specific cognitive skills that emerge during childhood and adolescence that are relevant to making sense of the mass media.


Figure 1.2 Percentage of respondents reporting fright responses to media themes as a function of age at time of exposure.

SOURCE: Adapted from Harrison and Cantor (1999).

The Media Environment and Habits of Today’s Youth A recent headline in the Detroit Free Press warned, “More Kids Vulnerable to Sexual Exploits Online” (Baldas, 2012). The article described an incident in which a 14-year-old boy visited an online chat room and interacted with a stranger who convinced him to expose himself on a webcam. According to research cited in the article, nearly half of American children (48%) between the ages of 10 and 17 say they have visited chat rooms, and one in 11 children (9%) has received an unwanted sexual solicitation online. Such statistics help to stir a sense of panic about the impact of media technologies on youth. But even more traditional forms of media can raise concerns. Reality programs on television feature the lives of teenage moms as they juggle adolescence with parenthood, and those of “real” housewives who seem obsessed with physical appearance and money. Rap artists such as Eminem and Lil Wayne celebrate hatred, revenge, and violence in their music. And video games have become


increasingly violent. A popular video game series called Call of Duty allows the player to take on the role of a soldier battling increasing levels of enemy violence, which occasionally results in the death of innocent parents and children.

There is no doubt that today’s youth are confronted with a media environment very different from the one faced by their grandparents or even their parents (see Figure 1.3). Terms such as digital television, texting, and Google did not even exist 20 or 30 years ago. One of the most profound changes concerns the sheer proliferation of media outlets and technologies. Children today live in a “multidevice, multiplatform, multichannel world” (Carr, 2007). The advent of cable and satellite television has dramatically increased the number of channels available in most homes today. Digital cable is multiplying this capacity. Many homes in the United States are also equipped with CD players, DVD players, personal computers, wireless Internet access, and digital cameras. At a very young age, then, children are learning about keypads, e-readers, touch screens, and remote controls.

As these technologies proliferate, they are changing the nature of more traditional media. The TV screen, which once provided a way to watch broadcast television, is now being used for a much wider range of activities, including online shopping, video-on-demand, and viewing digitally recorded photographs and home movies. Newspapers can still be delivered to the doorstep, but they can also be received online. In other words, old distinctions between the television screen and the computer screen or between print and broadcast are becoming less meaningful.

Figure 1.3

SOURCE: Baby Blues by Rick Kirkman and Jerry Scott. © 2006 Reprinted with permission of King Features Syndicate.


As media technologies are converging, so are the corporations that own them. In January 2011, the Federal Communications Commission (FCC) and the Justice Department approved the merger of Comcast, the largest cable operator in the United States, and NBC Universal, the well-known broadcasting company. Together, these two media giants own 10 TV and movie production studios; a number of national cable networks, including USA, MSNBC, Oxygen, and Bravo; over two dozen local NBC and Telemundo broadcast stations; two pro sports teams, four theme parks; and several digital media properties, including and iVillage. All of this, plus the merger, means access to more than 23 million video subscribers and nearly 17 million Internet subscribers. The deal represents a powerful integration of content and delivery, meaning that programming can be created, promoted, and delivered by a single corporation. This $30 billion megamerger is one of many examples of corporate synergy and partnership.

Such mergers have sparked heated debates in the United States about the dangers of monopolistic growth (Hiltzik, 2011; Silver, 2011). Furthermore, media corporations that were once primarily American-based now have major stakes in the international market. So our capitalistic, privately owned media system and the cultural messages we produce are being exported worldwide. And as these media industries grow, they are becoming increasingly commercial in nature. For example, advertising is now a regular part of the Internet (see Chapters 2 and 8) and is creeping into cable television and even movie theaters.

In the relentless search for new markets, media corporations are increasingly recognizing and targeting youth as a profitable group of consumers (see Chapter 2). Television networks such as Nickelodeon and the Cartoon Network are designed for young viewers; magazines such as J- 14, Teen Vogue, American Cheerleader, and Teen Voices are targeted to adolescents, particularly girls; and many websites are aimed specifically at children and adolescents. Poptropica, a site targeting 6- to 15-year-olds, allows children to create a “Poptropican” character to travel the many islands of Poptropica, solve mysteries at each location, and interact with other players in “multiplayer” rooms. Of course, there are game cards and toys available for purchase. Even technologies are being marketed to youth. Handheld gadgets such as the VTech MobiGo and the LeapFrog Leapster Explorer are popular among younger children, an age group that is also the target for specially designed smartphones (see Figure 1.4). By 2010, one in five (20%) American children between the ages of 6 and 11 had their own


cell phone (American Kids Study, 2010). Ownership increases dramatically by age; roughly 77% teens between the ages of 12 and 17 own a cell phone (Lenhart, 2012). And two out of three (67%) teens have a mobile device capable of connecting to the Internet (Rideout, 2012). The proliferation of such handheld devices means that children can experience media around the clock, seven days a week.

Figure 1.4 Technologies for young children.

Finally, digital technology is altering the very nature of media experiences. Images and sounds are more realistic than ever, further blurring the distinction between real-world and media events. By entering virtual worlds while riding on a school bus or sitting in their bedrooms, children can travel to different places, encounter strange creatures, and play adventurous and often violent games. And these new media are far more interactive, allowing youth to become participants in their quest for information, action, and storytelling.

How are the youth of today responding to this modern and complex media environment? A recent national study took an in-depth look at the media habits of American children (Rideout, Foehr, & Roberts, 2010). Surveying more than 2,000 children ages 8 to 18, the study documented that youth today are surrounded by media. The average child in the United States lives in a home with four TVs, two CD players, two radios, three DVD/VCR players, two console video game players, and two computers. More telling, the media have penetrated young people’s bedrooms. A full 71% of American children between the ages of 8 and 18 have a television in their room. Moreover, 49% have access to cable or satellite TV and 50% have a video game console in their room (see Figure 1.5). And one-third (33%) of


these young people have Internet access in their bedroom, up from 20% in 2005. Having a TV as well as a video game console in the bedroom is more common among both African American and Hispanic youth than among White and Asian youth (Rideout, Lauricella, & Wartella, 2011).

Figure 1.5 Proportion of children 8 to 18 years of age having various media in their bedroom.

SOURCE: Adapted from Rideout, Foehr, and Roberts (2010).

In terms of exposure, the average U.S. child between the ages of 8 and 18 spends seven and a half hours a day consuming media (Rideout et al., 2010). As noted by Rideout and her colleagues, the typical young person in this country spends roughly the same amount of time with media as most adults spend at work each day. Moreover, time spent with media keeps increasing. In 2005, youth spent an average of six and a half hours a day consuming media—a full hour less than in 2010. Even more critical is that most youth today engage in multitasking—using more than one medium at a time. When multitasking is taken into account, youth today consume a total of 10 hours and 45 minutes’ worth of media content during those seven and a half hours per day.

Despite all the technologies available, most of this time is spent watching television (see Figure 1.6). On average, American children watch four and a


half hours of TV content per day. Notably, “television” today is no longer just regularly scheduled programs on broadcast TV. It now includes DVDs of popular TV series and movies, on-demand TV, prerecorded content on TiVo and other digital recorders, and classic and current TV programs watched online using a laptop, iPad, or cell phone.

As it turns out, media use differs by race and ethnicity. Black, Hispanic, and Asian youth consistently spend more time consuming media each day than do White youth (Babey, Hastert, & Wolstein, 2013; Rideout et al., 2011). The biggest differences are in TV viewing: Black and Hispanic youth spend at least one hour more a day watching TV than White youth do (Rideout et al., 2011). In contrast, Asian youth spend about an hour more a day using the computer than do the other three groups. These differences hold up even after controlling for parents’ socioeconomic status and whether the child is from a single- or two-parent home.

Figure 1.6 Average amount of time children 8 to 18 years of age spend with each medium during a typical day.

SOURCE: Adapted from Rideout, Foehr, and Roberts (2010).

The national study by Rideout and her colleagues (2010) also revealed that parents typically do not exercise much control over their children’s media experiences. Less than half (46%) of the children reported that there


were rules in their home about what they could watch on TV, and less than one-third (30%) said there were rules concerning which video games they could play. In general, children more often have rules about the specific types of content they may consume than about the amount of time they may spend consuming it. In addition, the likelihood of having media rules decreases with age—30% of 15- to 18-year-olds reported having no rules at all about any type of media use, whereas only 3% of 8- to 10-year-olds reported no rules. Of course, when parents themselves are queried, they report supervising their children’s media use to a greater extent than their offspring report (Gentile, Nathanson, Rasmussen, Reimer, & Walsh, 2012). Underscoring the importance of parental oversight is the fact that children and teens who have a TV set in their bedroom spend substantially more time watching television than do those without a set in their room (Jordan et al., 2010; Rideout et al., 2010).

Computers are rapidly spreading in American homes, and so is Internet access. Today the vast majority of young people have a computer at home regardless of their parents’ education or race (Rideout et al., 2010). However, Internet access, especially high-speed wireless, still varies by demographics: White youth and youth whose parents are college educated are more likely to have high-speed access. The most popular computer activities for young people are visiting a social networking site such as Facebook, playing a computer game, and watching a video on a site such as YouTube.

Of course, one of the most dramatic changes in the media landscape is the explosion of mobile devices. Roughly two-thirds of young people between the ages of 8 and 18 own a cell phone, and nearly one-third have their own laptop (Rideout et al., 2010). It is rare these days to spend time with any teen who is not carrying a phone. And texting is a big part of teen communication (see Figure 1.7). One recent study found that the typical teen sends an average of 167 text messages a day (Lenhart, 2012). Older girls in particular have embraced this form of communication; girls between 14 and 17 years of age send an average of almost 200 texts a day, or 6,000 texts a month. Heavy texters are more likely to talk on their cell phones, more likely to spend time with friends outside of school, and more likely to use a social networking site than are their light-texting peers (Lenhart, 2012). In other words, heavy texters are socially active teens. Yet despite all these gadgets, teens report that they prefer using old-fashioned face-to-face communication to talk with friends (Rideout, 2012). Moreover, in a recent national survey of 1,000 13- to 17-year-olds, 43% agreed strongly or


somewhat that they wished they could “unplug” sometimes (Rideout, 2012). In addition, 41% reported that they would describe themselves as “addicted” to their cell phone.

Figure 1.7

SOURCE: Zits © 2005 Zits Partnership. Reprinted with permission of King Features Syndicate.

Most of the tracking of media habits has focused on older children and teens. However, infants and preschoolers are spending a fair amount of time with media as well. One national study surveyed over 1,000 parents of children ages 6 months to 6 years (Vandewater et al., 2007), age groups that many assume are too young to be involved much with media. Contrary to this assumption, the average American child between the ages of 6 months and 6 years spends about an hour and a half a day using media. Again, most of this time is spent watching television or videos and DVDs (see Figure 1.8). In fact, children younger than age 6 spend more time watching TV and videos than they do reading (or being read to) or playing outside. Perhaps most surprising, nearly 20% of children younger than age 3 have a TV set in their bedroom; roughly 40% of 3- to 6-year-olds have a TV in their room (see Figure 1.9). In a recent large-scale study of over 600 preschoolers, those who had a TV in their bedroom were significantly more likely to suffer from sleep problems, including daytime tiredness and difficulty falling asleep at night (Garrison, Liekweg, & Christakis, 2011).

American children are not so different from some of their counterparts abroad. One early study of more than 5,000 children living in 23 different countries found that the average 12-year-old spent three hours a day watching television (Groebel, 1999), a figure remarkably comparable to that found in the United States at the time. A more recent study of five Nordic countries (Denmark, Finland, Iceland, Norway, and Sweden) found that 95% of young people in this region have Internet access in the home, but


that television viewing remains the single most prominent leisure activity (Carlsson, 2010).

To summarize, youth today are confronted with a media environment that is rapidly changing. Technologies are proliferating, merging, more interactive, and mobile. Furthermore, the content featured in these technologies is increasingly graphic, realistic, and commercial in nature. At the same time, media use is at an all-time high. Youth today spend anywhere from one-third to one-half of their waking hours with some form of media (see Figure 1.10). Preteens and teens frequently are engaging in more than one media activity at a time, making estimates of overall exposure more challenging. And much of this media use is becoming more private as children carry smartphones throughout their daily activities and then retreat to their bedrooms to watch TV, play video games, listen to music, or text their friends. We will now highlight several developmental principles that underscore the need to consider youth as a special audience in today’s media environment.

Figure 1.8 Children spend a great deal of time watching television each day.

Figure 1.9 Television sets are common in American children’s bedrooms.


Figure 1.10

SOURCE: Zits © 2005 Zits Partnership. Reprinted with permission of King Features Syndicate.

Children Are Different From Adults Most adults believe that they personally are not affected much by the media. In a well-documented phenomenon called the “third-person effect,” people routinely report that others are more strongly influenced by the media than they themselves are (Perloff, 2009). As an example, a recent study found that undergraduates perceived themselves to be less likely to be harmed by


Facebook use in terms of privacy and future employment opportunities than were their closest friends, friends in their Facebook network, and even Facebook users in general (Paradise & Sullivan, 2012). This difference in perceived impact gets larger as the age of the “other” person decreases. In other words, adults perceive that the younger the other person is, the stronger the effect of the media will be (Eveland, Nathanson, Detenber, & McLeod, 1999). Interestingly, even children endorse a kind of third-person effect, claiming that only “little kids” imitate what they see on TV (Buckingham, 2000).

Are children more susceptible to media influence than adults are? At the extremes, there are two radically different positions on this issue (see Buckingham, 2011). One view is that children are naive and vulnerable and thus in need of adult protection. This stance sees the media as inherently problematic and in some cases evil because they feature material that children are simply not yet ready to confront. Buckingham (2000) points out that “media panics” have been with us a long time, especially those concerning the impact of sex and violence on children. Such panics gain steam any time a public crisis occurs, such as the massacre at Columbine High School, or any time a new and unknown form of media technology is developed (Wartella & Reeves, 1985).

A contrasting view is that children are increasingly sophisticated, mature, and media savvy (Livingstone, 2002). According to this position, efforts to shield youth from media are too protectionist in nature, smack of paternalism, and construe children as acted upon instead of actors. Instead, children should be empowered to take control of their own media experiences, negotiating and learning along the way. Buckingham (2000) noted that this position is widely shared among those who see children as independent consumers who should be able to spend their own money and buy what they want.

These very different perspectives illustrate that notions of childhood are constantly being defined, debated, and renegotiated over the course of history (James, Allison, Jenks, & Prout, 1998). In truth, neither of these extreme positions seems very satisfying. Children are not entirely passive in the face of the media, nor are they extremely worldly and discriminating. The reality is probably somewhere in between. Nevertheless, most parents, developmental psychologists, policymakers, and educators would agree that children are not the same as adults (see Figure 1.11).

Several features of childhood support this distinction. First, children



bring less real-world knowledge and experience to the media environment (Dorr, 1986). Every aspect of the physical and social world is relatively new to a young child, who is busy discovering what people are like, how plants grow, what animals eat, and where one neighborhood is located relative to another. As they get older, children explore increasingly abstract concepts and ideas such as the social norms of their culture, what prejudice is, and how life begins. In almost every arena, though, children possess a more limited knowledge base compared to adults.

One implication of this is that children can fail to understand a media message if they lack the background knowledge needed to make sense of the information. As an illustration, in 1996, researchers at the Children’s Television Workshop (now called Sesame Workshop) wanted to produce a Sesame Street segment about visiting the doctor. On the basis of preliminary interviews, the researchers discovered that preschoolers mostly associated doctor visits with getting shots and that they had little knowledge of the importance of such vaccinations (“Feeling Good,” 1996). Had the producers not discovered this, they might have created a script that focused too much on getting shots, inadvertently reinforcing children’s negative and limited impressions of the purpose of going to a physician.

Figure 1.11

SOURCE: Baby Blues © 2007 Baby Blues Partnership. Reprinted with permission of King Features Syndicate.

As another example, researchers working on the Sesame Street website wanted to create an activity that would help preschoolers learn about email. In developing the “Sesame Street Post Office,” the researchers discovered that preschool children have little, if any, experience with email or with composing letters (Revelle, Medoff, & Strommen, 2001). In other words, the children’s background knowledge was quite limited. Taking this into



account, the post office activity was designed to be very concrete by having the child choose a Muppet to email from a set of pictures of Muppets and then choose questions to ask from a set tailored to each Muppet. The child’s message was displayed on the screen before it was sent so that children could see how their choices influenced the composed letter. Researchers also determined that adding a “Dear [name of Muppet]” to the beginning of the email and a “Your friend, [name of child]” to the end of it helped children understand the conventions of letter writing.

The lack of real-world knowledge can also make children more willing to believe the information they receive in the media. It is difficult to evaluate a story for accuracy or truthfulness in the face of no alternative data. An adult watching a TV advertisement is able to evaluate that message in the context of knowledge about the television industry as well as a vast array of personal experiences with purchasing products. A child, on the other hand, rarely has this rich set of knowledge structures on which to rely. As an illustration, Figure 1.12 presents children’s perceptions of how truthful advertisements are (Chan, 2001). In a sample of over 400 children ages 5 to 12, a full 42% reported that television advertising is “mostly true.” Given this level of trust, a young child seems fairly defenseless when confronted with a slick TV ad that costs thousands of dollars to produce and may yield millions of dollars in sales profit.

A second feature that distinguishes childhood from adulthood is the strong eagerness to learn that marks the early years (Dorr, 1986). Parents find this tendency exhausting sometimes, as their infant daughter puts one more object in her mouth or their preschool son asks for the 20th time, “What’s that?” or “Why?” Such curiosity is a hallmark of childhood and is celebrated by educators. But it means that children are as open to learn from the mass media as from other sources, particularly in situations where firsthand experience is not possible. For example, most American children are not able to visit Japan, but they can learn about the country by reading a book or viewing a TV documentary. A preschooler can even watch Big Bird in Japan, a Sesame Workshop production available on DVD or even YouTube. These examples show the educational benefits of the media. Unfortunately, a child could also learn about Japan by visiting a website created by a hate group that disparages people of Asian descent.

Figure 1.12 Children’s (5–12 years of age) perceptions of the truthfulness of TV advertising.



SOURCE: Adapted from Chan (2001).

A third feature that characterizes childhood is a relative lack of experience with the media. Admittedly, these days some children are actually more media savvy than their parents are. Indeed, many children know how to take and store photos on a smartphone or program the digital video recorder while their parents still fumble with these technologies. One study found that 19% of children younger than age 6 were able to turn on the computer by themselves (Rideout & Hamel, 2006). But with most media, it is still the case that adults have spent more time with the technology. Adults readily appreciate, for example, that the placement of a story in a newspaper signals something about its importance, that public television is a noncommercial channel in contrast to the broadcast networks, and that there are different genres and subgenres of movies. In contrast, children often show an incomplete understanding of production techniques such as dissolves and split screens (Beentjes, deKoning, & Huysmans, 2001), have difficulty distinguishing nightly news programs from tabloid news shows such as Inside Edition and Current Affair (Wilson & Smith, 1995), and do not fully appreciate the commercial nature of most media in the United States (Dorr, 1980). This lack of familiarity with the technical forms and structure of the media makes a child less able to critically evaluate the content presented.

To summarize, children differ from adults in a number of ways that have implications for responding to the media. Younger age groups have less



experience with the real world and at the same time possess a strong readiness to learn about those things with which they are unfamiliar. They also tend to be less savvy about the nature, intricacies, and potential distortions of the media. Such naïveté makes a preschooler and even an elementary schooler more likely to believe, learn from, and respond emotionally to media messages than is a more mature and discriminating adult.

Children Are Different From Each Other It may be easier to recognize that children are different from adults than it is to appreciate how much children differ from one another. In some ways, the label children itself is misleading because it encourages us to think of a fairly homogeneous group of human beings. As the Monsters, Inc. example at the start of this chapter illustrates, a 4-year-old thinks and responds to the world very differently than a 10-year-old does. But even a group of 4-year- olds will exhibit marked differences in how they respond to the same situation. In fact, sometimes it is difficult to believe that two children are the same age or in the same grade level.

On any elementary school playground, kindergartners can be readily distinguished from 5th graders—they are shorter in height and normally weigh less. Their heads are smaller, they dress differently, and they tend to be more physically active. But even more profound differences exist in their cognitive functioning. Younger children attend to and interpret information in different ways than do their older counterparts. Several influential perspectives on children’s development support this idea, including Piaget’s (1930, 1950) theory of cognitive development as well more recent models of information processing (Flavell, Miller, & Miller, 2002; Siegler, 2005).

Age is often used as a marker of these differences in cognitive abilities, although there is tremendous variation in how and when children develop. Still, most research reveals major differences between preschoolers and early elementary schoolers (3–7 years of age) on the one hand and older elementary school children (8–12 years of age) on the other, in terms of the strategies they use to make sense of the world (Flavell et al., 2002). These strategies have important implications for how children respond to mass media, as will be discussed below in the section titled “Developmental Differences in Processing the Mass Media.”


Cognitive development is not the only factor that distinguishes children from each other. Personality differences also set children apart. For instance, some children are withdrawn or inhibited in unfamiliar situations, whereas others are not (Kagan & Snidman, 2004). Children also differ in the degree to which they possess prosocial dispositions toward others (Eisenberg, Fabes, & Spinrad, 2006), the degree to which they are capable of regulating their emotions (Stegge & Terwogt, 2007), and the degree to which they enjoy novel or stimulating situations (Zuckerman, 1994).

Research consistently shows sex differences among children, too. For example, girls tend to prefer activities that are less vigorous than the ones boys tend to choose (Eaton & Enns, 1986), and boys typically are more physically aggressive (Kistner et al., 2010). In terms of cognitive skills, girls generally obtain higher grades in school and do better on tests involving writing, whereas boys do better on visual-spatial tasks (Halpern, 2004).

The fact is that children, even those who share biological parents and are raised in the same environment, differ on many dimensions. And children themselves recognize these differences early in development. For example, children become aware of their own gender by around age 2 (Berk, 2000). During the preschool years, they begin formulating mental conceptions of activities, norms, attributes, and scripts that are associated with being male or female (Ruble et al., 2007). Young children’s initial understanding of gender as a social category is often based on superficial qualities such as hair length and dress. As they enter elementary school, children’s conceptions grow more sophisticated, and they become keenly interested in gender role information in the culture. They actively search for cultural meanings about gender in their homes, on the playground, and in the media (see Bussey & Bandura, 1999). In other words, the unique characteristics that differentiate children in turn get represented and reinforced in the culture.

All of these unique characteristics make it difficult to come up with a single prototype for what a child is like. Therefore, when we make generalizations about children and the media, we must be careful to take into account the developmental, personality, and gender characteristics of the individuals involved.

Adolescents Are Different From Children


Although we cannot generalize about all children, we can clearly differentiate them as a group from their older counterparts—teenagers. Parents certainly appreciate this transformation as they watch their warm, cuddly 12-year-old turn into an emotionally distant and independent 13- year-old. Of course, this developmental progression does not happen evenly or all at once. But the changes are reflected in a variety of activities and interests that a young person has, including media preferences. For example, children under the age of 12 prefer watching cartoons and animated movies on television, many of which involve fantasy themes (see Table 1.1). In contrast, viewers between the ages of 12 and 17 prefer reality shows and sitcoms that focus on teenage issues. There is some overlap in the list of top 10 TV programs for these two age groups, but the differences are striking.

Adolescence is often characterized as a time of challenge and turbulence (Roth & Brooks-Gunn, 2000). Along with bodily changes that can be quite dramatic, teens are faced with increased independence and growing self- discovery. Scholars of adolescent development refer to these changes as developmental transitions or passages between childhood and adulthood (Arnett, 1992a). In other words, the sometimes stormy periods are a necessary and normal part of growing up (Gondoli, 1999).

Unfortunately, parents and even the general public often view the teenage years with some trepidation. One national poll revealed that 71% of adults described teenagers negatively, using terms such as irresponsible and wild (Public Agenda, 1999). Some of this public opinion is likely fueled by the media’s preoccupation with high-profile cases of troubled teens who become violent. Contrary to public opinion, though, most teens are able to navigate adolescence in a socially responsible way, learning new competencies and new roles on the path to adulthood (Graber, Brooks- Gunn, & Petersen, 1996).

What are some of the developmental hallmarks of adolescence? One of the main challenges a teen faces is identity formation (Klimstra, Hale, Raaijmakers, Branje, & Meeus, 2010). During the teenage years, boys and girls alike begin to ask questions about who they are and how they differ from their parents. This emerging sense of the self is fragile and malleable as teens “try on” different appearances and behaviors. An article in Newsweek magazine described the teen years like this: “From who’s in which clique to where you sit in the cafeteria, every day can be a struggle to fit in” (Adler, 1999, p. 56). As this quote suggests, the process of identity formation is highly social in nature, with teens working to integrate different


facets of themselves as they encounter others at school, at work, and during leisure activities (Crosnoe & Johnson, 2011). Today’s youth even use the media to grapple with their identities. For example, one study of 20 female teen bloggers found that the girls used LifeJournal as a digital space for self-expression and “self-theorizing” (Davis, 2010). Another study found that 50% of 9- to 18-year-olds who used the Internet had pretended to be somebody else while communicating by email, instant messaging (IM), or chat (Valkenburg, Schouten, & Peter, 2005). Teens also spend a great deal of time posting photographs, videos, and personal information on popular websites such as Facebook, YouTube, and Twitter. As they experiment with ways of expressing themselves online, teens may be working through the psychosocial process of understanding who they are and how they feel about their emerging identity (Valkenburg & Peter, 2011).

Table 1.1 Top 10 Programs for the 2010–2011 Season


SOURCE: Copyrighted information of Nielsen, licensed for use herein.

A second challenge of adolescence is increased independence. Parents naturally feel less need to supervise a 13-year-old who, unlike a 5-year-old, can dress, study, and even go places alone. Teens often have jobs outside the home and by age 16 can typically drive a car, furthering their autonomy. In one study, the percentage of waking hours that teens spent with their families fell from 33% to 14% between the 5th and 12th grade (Larson, Richards, Moneta, Holmbeck, & Duckett, 1996).

Time away from parents can provide teens with opportunities to make



independent decisions. It also can allow for experimentation with a variety of behaviors, some of which are not very healthy. A large national study involving more than 90,000 adolescents in Grades 6 to 12 found strong differences between teens who regularly ate dinner with a parent and those who did not (Fulkerson et al., 2006). In particular, teens who spent less dinner time with parents showed significantly higher rates of smoking, drinking, depression, violence, and school problems, even after controlling for family support and family communication. The direction of causality is difficult to pinpoint here because it may be that troubled teens simply choose to spend less time at home. However, other studies have also documented the importance of parent involvement as a buffer against unhealthy behaviors during the teenage years (Cookston & Finlay, 2006).

This point leads us to a third feature of adolescence—risk taking. Today’s teens face tough decisions regarding a number of dangerous behaviors such as smoking, drug use, and sexual activity. And there is no doubt that adolescence is a time of experimentation with reckless activities (Santelli, Carter, Orr, & Dittus, 2009). For example, 1.4 million American youth under the age of 18 started smoking cigarettes for the first time in 2010 (National Survey on Drug Use and Health, 2010). Furthermore, a recent national survey revealed that 47% of 9th through 12th graders reportedly have had sexual intercourse (Centers for Disease Control and Prevention, 2011). The same study found that 17% of the teens had carried a weapon (i.e., gun, knife, or club) during the 30 days preceding the survey, 39% had drunk alcohol, 23% had used marijuana, and 40% of sexually active students had not used a condom (see Figure 1.13). Moreover, 24% had ridden in a vehicle in the last 30 days that was driven by someone who had been drinking.

Some of this risk taking may be a function of what scholars have labeled “adolescent egocentrism” (Elkind, 1967, 1985; Schwartz, Maynard, & Uzelac, 2008). In particular, teenagers often seem preoccupied with their own thoughts and appearance and assume others are equally interested in their adolescent experiences. This view of the self as unique and exceptional can in turn lead to a feeling of invulnerability to negative consequences (Greene, Krcmar, Walters, Rubin, & Hale, 2000). In other words, self-focused teens think they are different from everyone else and that tragedies occurring to others “won’t happen to me.” Indeed, studies show that teens routinely underestimate their own personal chances of getting into a car accident compared with the risks they assume others face (Finn & Bragg, 1986). Similar misjudgments have been found among



sexually active young girls who underestimate the likelihood that they themselves might get pregnant (Gerrard, McCann, & Fortini, 1983). One study linked this type of optimistic bias to teen smoking. Song, Glantz, and Halpern-Felsher (2009) surveyed over 300 ninth graders every six months for two years. They found that adolescents who perceived low risk associated with being exposed to secondhand smoke were more likely to start smoking in subsequent months than were those who perceived secondhand smoke to be risky. Risk taking can also be viewed as an adolescent’s effort to assert independence from parents and to achieve adult status (Jessor, 1992). However, not all teens engage in reckless behaviors, and even the ones who do seldom limit their activities to those legally sanctioned for adults. Arnett (1995) argued that risk taking must be viewed in the larger context of an adolescent’s socialization. Some teens experience narrow socialization, which he characterized as involving strong allegiance to the family and community, clear expectations and responsibilities, unambiguous standards of conduct, and swift sanctions for any deviation from those standards. Other teens are raised in an environment of broad socialization, where independence and autonomy are encouraged, standards of conduct are loose or even self-determined, and enforcement of standards is lenient and uneven. Arnett argued that in addition to parents, the schools, the legal system, and even the media contribute to these overarching patterns of socialization. As might be expected, risk taking is more prevalent in cultures in which socialization is broad rather than narrow (see Arnett, 1999, for a review).

Figure 1.13 Percentage of U.S. high school students who reported engaging in risk-related behaviors over the last two decades.



SOURCE: Adapted from Centers for Disease Control and Prevention (2012).

A fourth feature of adolescence is the importance of peers. Teens spend a great deal of time with friends and place a high value on these relationships (Rubin, Bukowski, & Parker, 2006). On average, teens spend up to one- third of their waking hours with friends (Hartup & Stevens, 1997). In her controversial book The Nurture Assumption: Why Children Turn Out the Way They Do, Judith Harris argued that parents have a minimal influence on their child’s development other than to nurture and shape the child’s peer group (Harris, 1998). Peer groups certainly do make a difference during adolescence. Studies have documented the role of peers in the initiation and continuation of behaviors such as cigarette smoking (Scherrer et al., 2012), drug use (Creemers et al., 2009), and sexual intercourse (Whitbeck, Yoder, Hoyt, & Conger, 1999). Engaging in reckless behavior often helps a teen become a member of a peer group, and the group itself can foster a sense of collective rather than individual invincibility (Arnett, 1992a).

But peer influence is not as straightforward and not necessarily as negative as some might assume. Friends actually can be a source of support



for teens and can also increase self-esteem (Wilkinson, 2004). Generally, adolescents are more susceptible to antisocial peer pressure when they have more delinquent than nondelinquent friendships (Haynie, 2002), when they have poorer relationships with their parents (Dishion, 1990), and when they are alienated from community support structures such as schools (Arnett, 1992b; Resnick et al., 1997).

Last but not least, puberty and sexual development are hallmarks of adolescence. Body hair, acne, muscle growth, and weight gain are only a few manifestations of the dramatic physical changes that occur during the teenage years. Puberty typically begins during early adolescence, around age 9 or 10 for girls and roughly one to two years later for boys (Archibald, Graber, & Brooks-Gunn, 2003), although there are large individual variations. As their bodies change, many teens also experience an increased energy level as a function of significant changes in their endocrine system (Petersen & Taylor, 1980). Furthermore, increased production of androgens and estrogens stimulates the growth of reproductive organs (see Rekers, 1992).

As might be expected, the hormonal and physical changes associated with puberty are accompanied by an increased interest in sexuality. In one study, for example, 12- to 15-year-old girls who were more physically mature (i.e., had experienced earlier puberty) reported a greater interest in seeing sexual content in the movies, television, and magazines than did those who were less mature (J. D. Brown, Halpern, & L’Engle, 2005). Thus, at some point during adolescence, most teens will become intensely curious about sex and will seek information about sexual norms, attitudes, and practices in their culture. It is no accident, then, that popular teen magazines devote a great deal of space to sexual issues and relationships (Walsh-Childers, 1997).

Whether the teenage years are characterized as tempestuous or transitional, there is no doubt that significant developmental changes occur during this period. Adolescents spend more time alone or with friends and less time with parents. This growing independence comes at the same time that teens are exploring their identities and their sexuality. The challenge is to provide these young people with enough latitude as well as guidance so that the decisions they make will result in a healthy rather than risky lifestyle.



Developmental Differences in Processing the Mass Media So far, we have focused on broad developmental features that characterize childhood and adolescence and that differentiate these periods from adulthood. Now we will turn our attention more directly to young people’s interactions with the media. Any individual who confronts a mediated message must make sense of and interpret the information presented. Like adults, children and adolescents construct stories or readings of media messages that they encounter (Dorr, 1980). Given some of the pronounced differences in experience and maturation described above, we can expect that interpretations of the same content will vary across the life span. That is, a young child is likely to construct a different story from a TV program than an older child or teenager will.

These different interpretations may seem “incorrect” or incomplete to an adult viewer. But even among mature adult viewers, there are differences in how people make sense of stories. For example, one early study looked at people’s reactions to the 1970s TV sitcom All in the Family, featuring a bigoted character named Archie Bunker (Vidmar & Rokeach, 1974). The research revealed that interpretations of the program varied widely based on individual attitudes about race. Viewers who held prejudiced attitudes identified with Archie Bunker and saw nothing wrong with his racial and ethnic slurs (see Figure 1.14). In contrast, viewers who were less prejudiced evaluated Archie in negative ways and perceived the program to be a satire on bigotry.

What cognitive activities are involved when a young person watches a television program, enjoys a movie, or plays a video game? In general, five mental tasks are involved (Calvert, 1999; Collins, 1983). First, the child needs to select important information for processing. When viewing television, for example, a multitude of auditory and visual signals are presented in a particular program or advertisement. Moreover, there are cues in the environment that often compete with the television, such as family members talking in the background or loud music from another room. A viewer must allocate attention to these myriad cues, consciously or unconsciously filtering out what is not essential and instead focusing on what is important in the situation.

Figure 1.14 Adults’ reactions to the TV show All in the Family as a


function of viewer prejudice.

SOURCE: Adapted from Vidmar and Rokeach (1974).

Second, the child needs to sequence the major events or actions into some kind of story. Most media messages feature a narrative or storyline (Grossberg, Wartella, & Whitney, 1998). Television plots are the easiest example of this, but even an advertisement, a video game, a song, or a radio program conveys a story.

Third, the child needs to draw inferences from implicit cues in the message. The media do not have the space or the time to explicitly present all aspects of a story. Television programs jump from one location to another, characters in movies have dreams or experience flashbacks, and even characters in video games travel in ways that are not always orderly or linear. A sophisticated consumer recognizes the need to “read between the lines” to fill in the missing information. But a young child may fail to recognize that time has passed between scenes (Smith, Anderson, & Fischer, 1985), that the events depicted are only part of a dream (Wilson, 1991), or that a flashback to earlier events in the plotline has occurred (Durkin & Lowe, 1999).

Fourth, to make sense of both explicit and implicit cues in the message, a child must draw on the rich database of information he or she has stored in memory that relates to the media content. For instance, a child who lives in a rural community will have an easier time making sense of a movie about a family that loses a farm to bank foreclosure than will a child who lives in an



apartment complex in New York City. This rich set of past experiences and acquired knowledge forms a mental database that helps a child interpret new messages.

Fifth, the child will typically evaluate the message in some way. The simplest evaluation pertains to liking or not liking the message. Children as young as 2 years of age already show preferences for certain types of TV programs, such as those featuring puppets and young characters (Lemish, 1987; Rideout & Hamel, 2006). One mother described her preschool daughter’s attachment to a televised purple dinosaur in the following way: “She played the Barney tape every single hour that she was awake the entire weekend. And if we tried to turn it off, she’d be screaming, yelling, crying” (Alexander, Miller, & Hengst, 2001, p. 383). As children grow older, they become increasingly sophisticated and critical of media messages (Potter, 2010). Not only are they capable of evaluating the content, but they also begin to appreciate the forms, economic structure, and institutional constraints that characterize different media (Dorr, 1980). An adolescent, for example, may reject all mainstream American television programming because of its inherent commercialism.

Given this set of tasks, we can expect that children will process media messages in different ways across development. We now describe some of the major shifts in cognitive processing that occur during the transition from early to middle childhood and during the transition from late childhood to adolescence. By no means is this list exhaustive; instead, it reflects some of the skills that are most relevant to interacting with the media (for further reading, see Dorr, 1980; Flavell et al., 2002; Wilson & Drogos, 2009). We will end this chapter with a topic receiving a great deal of interest these days: How do infants and toddlers interact with the media?

Two caveats need to be noted here. First, most of the changes highlighted below occur gradually rather than abruptly during development (Flavell et al., 2002). Piaget (1950, 1952) argued that younger children’s thinking is qualitatively different from that of older children, such that their cognitive systems progress through distinct stages (i.e., sensorimotor, approximately 0–2 years of age; preoperational, 2–7 years; concrete operational, 7–11 years; formal operational, 11 years and older). However, research indicates that cognitive performance can be uneven across different types of tasks and that children exhibit varied skill levels even within a particular domain (Siegler, 2005). Thus, it is widely believed that development is far less stagelike or abrupt than Piaget’s theory would have us believe.



Second, the ages during which these shifts occur vary markedly across children. For rough approximations, we define younger children as those between 2 and 7, older children as those between 8 and 12, and adolescents as those between 13 and 18.

Younger Children Versus Older Children

From Perceptual to Conceptual Processing. Preschoolers pay close attention to how things look and sound. This focus on salient features has been referred to as perceptual boundedness (Bruner, 1966). Perceptual boundedness is defined as an overreliance on perceptual information at the expense of nonobvious or unobservable information that may be more relevant (Springer, 2001). For example, preschoolers frequently group objects together based on shared perceptual features such as color or shape (Bruner, Olver, & Greenfield, 1966; Melkman, Tversky, & Baratz, 1981). In contrast, by age 6 or 7, children have begun sorting objects based on conceptual properties such as the functions they share (Tversky, 1985). With regard to the media, studies show that younger children pay strong visual attention to perceptually salient features such as animation, sound effects, and lively music (Anderson & Levin, 1976; Calvert & Gersh, 1987; Schmitt, Anderson, & Collins, 1999). Older children, on the other hand, tend to be more selective in their attention, searching for cues that are meaningful to the plot rather than those that are merely salient (Calvert, Huston, Watkins, & Wright, 1982).

One creative experiment involving television revealed this distinction quite clearly. Hoffner and Cantor (1985) exposed children to a television character who was either attractive or ugly and who acted kind toward others or was cruel (see Figure 1.15). Preschoolers generally rated the ugly character as mean and the attractive character as nice, independent of the character’s actual behavior. In other words, their evaluations were strongly affected by the character’s physical appearance. Older children’s judgments, in contrast, were influenced more by the character’s behavior than her looks.

Why are younger children so perceptual in their focus? Tversky (1985) has argued that all children can be swayed by strong perceptual cues in a situation, but that as they develop children come to suppress immediate, salient responses in favor of slower, more thoughtful ones. This shift is undoubtedly fostered by the acquisition of knowledge that is conceptual in



nature, such as the idea that motives are an important predictor of behavior. Children of all ages, and even adults, are also less likely to be swayed by perceptual cues when they are dealing with situations and tasks that are familiar (Springer, 2001).

We can apply this developmental trend in perceptual boundedness to the example at the beginning of this chapter. The preschool child is transfixed by the monsters’ strange physical appearance, reacting with fright when she sees their distorted forms. In contrast, the older child is able to minimize the characters’ looks and instead focus on the creatures’ behavior and motivation.

From Centration to Decentration. As noted above, children and even adults can respond strongly to salient features in a message. But another characteristic of younger children’s thinking is that they often focus on a single striking feature to the exclusion of other, less striking features. This tendency has been called centration and is illustrated in some of Piaget’s classic liquid conservation tasks (see Ginsburg & Opper, 1979). In these tasks, a child is shown two glasses containing identical amounts of water. Once the child agrees that the amounts are identical, the experimenter pours the water from one glass into a third glass, which is taller and thinner (see Figure 1.16). The experimenter then asks the child whether the two amounts of liquid are still identical or whether one glass now contains more water. The typical preschooler concludes that the taller glass has more liquid in it. Why? Because the taller glass looks as if it has more in it. In other words, the differential height of the liquids captures most of the preschooler’s attention.

Figure 1.15 Four characters differing in appearance and behavior.



SOURCE: From Hoffner and Cantor (1985). Copyright ©American Psychological Association. Reprinted with permission.

In contrast, older children are increasingly able to “decenter” their attention and take into account the full array of perceptual cues. The liquid in one glass is higher, but that glass also has a different shape to it. It is taller and thinner. Also, pouring the liquid from one container to another does not change the quantity. The amount of liquid stays the same. By recognizing that the liquid is the same, the older child is able to conserve continuous quantities.

The same developmental differences are found with other types of conservation tasks. For example, two rows of six pennies can be laid out next to one another in one-to-one correspondence. If one row is then compressed, a younger child is likely to perceive it as containing fewer coins because it is now shorter (Ginsburg & Opper, 1979). In contrast, the older child notes all the perceptual data in the situation and recognizes that the number of pennies is unchanged or “conserved” despite appearances.

Figure 1.16 A typical Piagetian conservation task.


O’Bryan and Boersma (1971) documented these differences further by examining children’s eye movements during conservation tasks. They found that younger children who are unable to conserve or master the task correctly tend to fixate on a single dimension, such as the height of the liquid in a glass. Older children who are able to conserve show more varied eye movements, shifting their gaze over many parts of the testing display.

Applying the idea of centration to the media, younger children are likely


to respond strongly to a single feature in a television or movie scene, such as a character’s red dress or a hero’s shiny weapon. The prominence of the cues as well as the child’s own interests will help determine what is most salient. Other perceptual cues such as the character’s hair color, name, physical size, and even certain overt behaviors may go unnoticed. In emotional stories, for example, a character’s feelings are often conveyed through facial expressions as well as situational information in the plot. Younger children will be more likely to fixate on one or the other of these sets of cues, even when they conflict (Wiggers & van Lieshout, 1985). Thus, in some cases, we can expect that this centration will interfere with a young child’s comprehension of the storyline (see Figure 1.17).

From Perceived Appearance to Reality. Another important cognitive skill during childhood concerns the ability to distinguish fantasy from reality. Much to a parent’s amazement, a 3-year-old child may attribute life to an inanimate object such as a rock, have an invisible friend, and want Dora from Dora the Explorer to come over to the house for a play date. All of these tendencies reflect a fuzzy separation between what is real and what is not.

Numerous studies have found strong developmental differences in children’s perceived reality of television (see Dorr, 1983; Wright, Huston, Reitz, & Piemyat, 1994). Younger children between the ages of 2 and 3 show little understanding of the boundary between television and the real world (Jaglom & Gardner, 1981). In fact, at this age, children routinely talk to the television set and wave at the characters (Noble, 1975). For example, in one study, many 3-year-olds reported that a bowl of popcorn shown on TV would spill if the television set were turned upside down (Flavell, Flavell, Green, & Korfmacher, 1990).

By around age 4, the young child begins to appreciate the representational nature of television but still tends to assume that anything that looks real is real (M. H. Brown, Skeen, & Osborn, 1979). This literal interpretation has been called the “magic window” perspective, reflecting the idea that young children naively assume that television provides a view of the real world. Gradually, children come to appreciate that some of what is shown on television is not real, although most of this centers first on perceptual cues. For example, 5-year-olds typically judge cartoons as not real because they feature physically impossible events and characters (Wright et al., 1994). In other words, the young child assesses content by looking for striking violations of physical reality (Dorr, 1983). It is important to note, though,



that these emerging distinctions are initially quite fragile. Young children may be able to report that an animated character is “not real” yet still become quite frightened of it (Cantor, 1998). In one study (Woolley, Boerger, & Markman, 2004), preschoolers were introduced to a novel fantasy creature named the “Candy Witch,” and even 5-year-olds believed she was real and not “pretend,” particularly if the witch purportedly visited their homes at night and left candy. In a more recent study, 5-year-olds were just as willing to follow advice from a computer-generated TV character as from a live person, whereas 7- and 9-year-olds responded only to the person (Claxton & Ponto, 2013).

Figure 1.17

SOURCE: PEANUTS reprinted by permission of United Features Syndicate, Inc.

As children mature, they begin to use multiple criteria for judging reality in the media (Hawkins, 1977). Not only do they notice marked perceptual cues, but they also take into account the genre of the program, production cues, and even the purpose of the program. Most important, older children begin to judge content based on how similar it is to real life (M. H. Brown et al., 1979). Although they recognize that much of television is scripted, older children are likely to judge a scene or a program as realistic if it depicts characters and events that are possible in the real world (Dorr, 1983; Hawkins, 1977). In one survey, 28% of 2nd and 3rd graders and 47% of 6th graders spontaneously referred to “possibility” criteria in judging whether a series of characters and events on television were realistic (Dorr, 1983). In contrast, only 17% of kindergartners used this type of criteria. These trends are congruent with research on language comprehension, which suggests that the concept of possibility is not fully understood until around 8 years of age (Hoffner, Cantor, & Badzinski, 1990; Piaget & Inhelder, 1975).

Obviously, a child’s personal experiences will place a limit on how


sophisticated these reality judgments can be. As an illustration, Weiss and Wilson (1998) found that elementary schoolers rated the TV sitcom Full House as very realistic, indicating on average that “most” to “all” real-life families are like the family featured in this program. These perceptions seem a bit naive given that the program was about a widowed father raising his three daughters with live-in help from his brother-in-law and his best friend.

Additionally, the nature of the media will have an impact. Computer games and other technologies that employ virtual reality can simulate the perceptual and social features of the real world. Interacting in such environments may tax a young person’s cognitive capacity, making it difficult even for an older child to distinguish fantasy from reality.

From Concrete to Inferential Thinking. A final cognitive trend during childhood that has implications for the media is the shift from concrete to inferential thinking. As we have mentioned above, a young child’s thinking is very tangible, focusing closely on what can be seen and heard (Bruner, 1966). For a 2- or 3-year-old, this means that attention can be swayed by highly salient cues that may actually be extraneous to the plot (Schmitt et al., 1999). For example, a bright red costume may get more attention than the actions of the character who is wearing this garment.

By age 4, children can begin to focus more on information that is central to the plot than on incidental details (Lorch, Bellack, & Augsbach, 1987). Of course, younger children do best with age-appropriate content, programs that are relatively short in duration, and comprehension tests that assess forced-choice recognition rather than spontaneous recall (Campbell, Wright, & Huston, 1987). With development, children become increasingly able to extract events that are central to the storyline in a program (Collins, 1983; Durkin & Lowe, 1999). Yet the information younger children focus on is still likely to be fairly explicit in nature. For example, one study found that 4- and 6-year-olds most often recalled actions after watching televised stories, whereas adults most often recalled information about characters’ goals and motives (van den Broek, Lorch, & Thurlow, 1996). Actions are typically concrete and fairly vivid in television programming, making them easy to understand and represent in memory. Another study found that a majority of kindergartners thought an episode of Clifford the Big Red Dog was a story about dogs interacting, which meant they took the story quite literally (Mares & Acosta, 2008). At this young age, they missed the overarching moral lesson about social tolerance and inclusiveness. As



discussed above, full comprehension involves apprehending not only explicit content but also implicit information in the unfolding narrative. For instance, in one scene, a protagonist might discover that a “friend” is trying to steal his money. In a later scene, the protagonist might hit the friend. The viewer must deduce that the protagonist’s aggression, which in isolation might appear unprovoked, is actually motivated by a desire to protect personal property. In other words, the viewer must link scenes together and draw causal inferences about content that is not explicitly presented. Studies show that older children are better able than their younger counterparts to draw different types of inferences from verbally presented passages (Ackerman, 1988; Pike, Barnes, & Barron, 2010). The same pattern emerges in the context of mediated messages. By roughly age 8 or 9, children show substantial improvements in their ability to link TV scenes together and draw connections between characters’ motives, behaviors, and consequences (Collins, Berndt, & Hess, 1974; Collins, Wellman, Keniston, & Westby, 1978; Kendeou, Bohn-Gettler, White, & van den Broek, 2008). This shift from concrete to inferential processing has implications for other forms of media as well. A video game and even a website require the user to make connections across space and time.

To summarize, a number of important cognitive shifts occur between early and middle childhood. A preschooler watching screen media is likely to focus on the most striking perceptual features in a program. This child may comprehend some of the plot, especially when the program is brief and age appropriate. Yet comprehension will be closely tied to concrete actions and behaviors in the storyline. In addition, the preschooler is likely to have difficulty distinguishing reality from fantasy in the portrayals. As this same child enters elementary school, she will begin to focus more on conceptual aspects of the content such as the characters’ goals and motives. She increasingly will be able to link scenes together, drawing causal connections in the narrative. And her judgments of reality will become more accurate and discriminating as she compares media content with that which could possibly occur in the real world. Clearly, her overall understanding of a media message is quite advanced compared with what she was capable of as a preschooler. Nevertheless, her skills are continuing to develop even during her later elementary school years. Next we will explore some of the cognitive shifts that occur between late childhood and adolescence.

Older Children Versus Adolescents


From Real to Plausible. As described above, older children use a variety of cues to judge the reality of media content. One of the most important yardsticks for them is whether the characters or events depicted in the media are possible in real life (Morison, Kelly, & Gardner, 1981). Adolescents become even more discriminating on this dimension, judging content as realistic if it is likely or probable in real life (Dorr, 1983; Morison et al., 1981). In Dorr’s (1983) research, almost half of adolescents defined real television events as those that were probable or plausible in real life. In contrast, probability rationales were seldom used by older elementary school children. To illustrate this distinction, a movie featuring an evil stepfather who is trying to poison his stepchildren may be very upsetting to a 9- or 10-year-old because this scenario could happen in real life. A teenager, on the other hand, is less likely to be disturbed by such content, reasoning that the vast majority of stepfathers in the world are not murderers. The movement to probabilistic thinking is consistent with studies of language comprehension that indicate that the ability to differentiate probability from possibility crystallizes during early adolescence (Piaget & Inhelder, 1975; Scholz & Waller, 1983).

From Empirical to Hypothetical Reasoning. A related development that occurs between late childhood and early adolescence is the shift from empirical to hypothetical reasoning (Flavell et al., 2002). Adolescents become increasingly able to understand abstract concepts, use formal logic, and think hypothetically (Byrnes, 2003). Along with this abstract thinking comes an ability to engage in inductive and deductive reasoning (Keating, 2004) as well as conditional reasoning (Gauffroy & Barrouillet, 2011). An older child is able to reason conceptually too, but much of this process is based on collecting empirical evidence. A 5th or 6th grader, for example, may watch a person’s behavior across several situations and infer from these actions what the person’s motives are. In contrast, an adolescent might begin with a theory or hypothetical set of motives for a person and then observe behaviors to see if the theory is correct. In other words, the teenager is capable of more abstract thinking that need not be tied too closely to observable data.

Adolescents are also increasingly capable of suspending their own beliefs to evaluate the reasoning of someone else (Moshman, 1998). Put another way, teens can sometimes reason about arguments at an objective level.

The ability to think hypothetically means that a teenager can anticipate



different plot events and predict logical outcomes as a storyline unfolds. The teen is also able to critique the logic and causal structure of different media messages. As abstract thought flourishes, the adolescent may also consider the meaning behind the message (e.g., “Who is the source of this website, and why is it constructed this way? How would the content differ if it were designed by someone else with different motives?”).

Metacognitive Thinking. Metacognition refers to the ability to understand and manipulate one’s own thought processes (Metcalfe & Shimamura, 1994). It is called metacognition because it refers to second-order mental activities: A person thinks about his or her own thinking. Adults routinely reflect on their own cognitive processing, especially during situations that highlight the need to do so. For instance, studying for a test or actually taking one requires a person to concentrate carefully on cognitive enterprises such as attention, comprehension, and memory.

Flavell and his colleagues (2002) have distinguished between two types of metacognition: metacognitive knowledge and metacognitive monitoring and self-regulation. Metacognitive knowledge refers to a person’s knowledge and beliefs about the human mind and how it works. For example, most adults realize that short-term memory is of limited capacity (see section below on processing capacity), that it is generally easier to recognize something when you see it than to recall it outright, and that certain tasks are more difficult and demanding of the human mind than others. But young children do not necessarily possess such metacognitive knowledge. In one study, for example, Lovett and Flavell (1990) presented 1st graders, 3rd graders, and undergraduates with three tasks: a list of words to be memorized, a list of words to match up with a picture, and a list of words to memorize and match. Unlike the 1st graders, the 3rd graders and the undergraduates were able to select which strategy—rehearsal, word definition, or both—would work best for each task. Yet only the undergraduates understood that the tasks would be more difficult with longer lists and unfamiliar words. Thus, as children develop, they become increasingly aware that the mind engages in a range of activities, including memory, comprehension, and inference (Flavell et al., 2002).

The second type of metacognition involves monitoring and readjusting one’s ongoing thinking. Consider the test taking instance, for example. An adult who is having difficulty with a certain section on a test might decide to jump ahead to an easier part for efficiency’s sake and to build confidence before returning to the harder material. Research suggests that this type of



self-monitoring is difficult during early childhood (see Flavell et al., 2002). In one study, preschoolers and elementary schoolers were instructed to examine a set of objects until they were sure they could recall them (Flavell, Friedrichs, & Hoyt, 1970). Older children examined the objects for a period of time, determined they were ready, and typically recalled all the items correctly. In contrast, the preschoolers examined the items, thought they were ready, and generally failed on the recall test. In other words, the preschoolers were not capable of monitoring their memory processes very accurately.

How do metacognitive knowledge and monitoring relate to the media? We can expect that as children approach adolescence, they will be better able to analyze the cognitive demands of different media and even different messages within a particular medium. According to Salomon (1983), some media require more nonautomatic mental elaborations or more AIME (amount of invested mental effort) than others. In general, television requires less effort and concentration than reading, for example, because the former is highly visual and relies less on language skills (Salomon & Leigh, 1984). Thus, a teenager is more likely than a young child to recognize that a difficult book or a television documentary requires higher concentration than watching a music video. Their awareness of different media will affect the depth of processing they use, which in turn should enhance comprehension and learning. Interestingly, when children are instructed to pay attention to and learn from TV, their mental effort and performance increase compared to what they do without such instruction (Salomon, 1983).

Nevertheless, the trend toward multitasking with media may make it difficult for even the most sophisticated teen to recognize the cognitive overload in such situations (see Cantor, 2009). Recent research indicates that people experience substantial declines in performance when they try to do more than one thing at a time (Bowman, Levine, Waite, & Gendron, 2010). For example, driving performance suffers when people simultaneously text on their cell phones (Owens, McLaughlin, & Sudweeks, 2011). Despite their metacognitive abilities, teens and young adults alike are fairly naive about how well they can study for an exam while monitoring Facebook, texting on their phones, and listening to music all at the same time.

Last, as children reach the teenage years, they should increasingly be able to monitor their own affective reactions to the media, for example, avoiding


classical music they do not like or reminding themselves that “it’s only a movie” when they feel scared. In one illustration of this, preschoolers and 9- to 11-year-olds were given different types of instructions on how to think about a frightening program they were about to watch on television (Cantor & Wilson, 1984). Children were told either to imagine themselves as the protagonist (role taking set) or to remember that the story and the characters were make-believe (unreality set). The cognitive-set instructions had no appreciable effect on the preschoolers’ emotional reactions to the program. In other words, they showed little ability to use the information to alter how they perceived the program. In contrast, older children in the role taking condition were more frightened by the program, and those in the unreality condition were less frightened, compared with a control group that received no instructions at all (see Figure 1.18). The findings are consistent with the idea that as children develop, they are increasingly able to modify their thought processes while watching television.

Regulatory Competence. Adults have long assumed that much of cognitive growth occurs during the childhood years. Recent research on the brain contradicts this view. With better measurement tools such as magnetic resonance imaging (MRI), we are beginning to realize that there are substantial changes in brain development during adolescence (Spear, 2010). Much of this development occurs in the prefrontal cortex region of the brain, which is crucial to the regulation of behavior and emotion (Sowell, Trauner, Gamst, & Jernigan, 2002). Until this area of the brain is fully developed, which may not occur until the mid-20s, young people often have difficulty regulating and controlling their moods and responses to different situations. This development of an “executive suite” or executive function is receiving considerable attention these days (Steinberg, 2005), in part because it signals that our conception of “adulthood” may need to be adjusted. Consistent with this idea, scholars have now adopted the term “emerging adulthood” to characterize young people between the ages of 18 and 25 (Arnett, 2007).

Executive functioning appears to play a crucial role in how young people respond to risk. One recent study found that teens who scored low on a battery of tests that measured executive control engaged in significantly more risky behavior than did those with higher executive control, even after controlling for risky personality traits, sex, and age (Pharo, Sim, Graham, Gross, & Hayne, 2011). Executive functioning not only varies individually but also across adolescence, generally showing gradual improvement with age (Watson, Lambert, Miller, & Strayer, 2011). Therefore, younger



adolescents will typically show less maturity and more risk taking when they confront various dilemmas in life, including those mediated by technologies. For example, younger teens are more likely than older ones to play with their identity in Internet communications (Valkenburg et al., 2005). Younger teens are also more likely than older teens to talk with strangers on the Internet (Jochen, Valkenburg, & Schouten, 2006).

Figure 1.18 Children’s self-reported fear reactions to a scary program as a function of instructional set.

SOURCE: Adapted from Cantor and Wilson (1984).

Two Overall Developmental Trends Two other important trends occur continuously throughout childhood and

adolescence and are not specific to particular age groups: (a) increasing knowledge about the social, physical, and mediated world in which we live and (b) increasing processing capacity.

Increase in Domain-Specific Knowledge. It may seem obvious to state that children gain increasing amounts of knowledge across different domains as they grow. But the point is still worth making because it has such important implications for interacting with the media. With each new experience, a child stores more and more information in highly organized ways in memory. The resulting knowledge structures, sometimes called mental templates or schemas, are powerful organizers that help children anticipate



and assimilate new information (Fiske & Taylor, 1991). Research suggests that children as young as 3 years of age possess well-developed schemas or scripts for familiar events, such as getting ready for bed and taking a bath (Hudson, Sosa, & Shapiro, 1997). As evidence of the power of these mental organizers, a young child is likely to protest quite strongly if someone tries to alter these routines.

Young children also develop schemas for stories that include information about the typical structure and components of a narrative (Mandler, 1998). Research suggests that a well-developed story schema can help a child to organize and interpret television programming (Meadowcroft & Reeves, 1989). In addition, children can form schemas about the social and physical world in which they live. In the social realm, for example, children develop templates for emotions that include information about expressive signals, situational causes, and display rules associated with each affect (e.g., Campos & Barret, 1984). These schemas undoubtedly assist a child in making sense of an emotional scene on television. In turn, such schemas can be shaped and modified by exposure to the media (see Wilson & Smith, 1998).

Not surprisingly, children develop schemas about the media as well (Calvert, 1999). Each form of the media has its own special audiovisual techniques and codes, which at least in the case of television have been referred to as “formal features” (Bickham, Wright, & Huston, 2001; Huston & Wright, 1983). Television and film, for example, use production techniques such as cuts, zooms, fades, and special effects to signal shifts in time and changes in setting. Video games and computers have their own technological conventions. A user of the World Wide Web, for example, needs some understanding of search engines and hypertext. Knowing what to expect from each medium greatly increases a child’s sophistication in using it (Calvert, 1999; Smith et al., 1985). For this reason, efforts to teach youth to become critical consumers of the media often include instruction on the conventions of different technologies (see Chapter 13).

In addition to developing schemas about the media, children can actually enhance their cognitive thinking by spending time with certain technologies (see Subrahmanyam & Greenfield, 2008). For example, studies show that practicing certain types of video games can improve dynamic spatial skills in both children (Subrahmanyam & Greenfield, 1996) and adults (Feng, Spence, & Pratt, 2007). There is also evidence that video game playing improves strategies for dividing visual attention, presumably because


players must cope with events that occur simultaneously at different places on the screen (Greenfield, deWinstanley, Kilpatrick, & Kaye, 1996). In addition, listening to a song seems to stimulate imagination more than watching a music video of the same song does (Greenfield et al., 1987). All of these studies suggest a kind of interactive relationship between media exposure and schematic processing and development.

To summarize here, children can call on larger stores of remembered information across a variety of domains as they grow. In addition, they can integrate and combine information in more complex ways, forming more elaborate connections with what they already know (Siegler, 2005). In other words, their schemas become more elaborate and differentiated, and thus their interpretations of media content become richer and more complex.

Having a great deal of knowledge and experience in a given area has all kinds of benefits for cognitive processing. Compared to a beginner, a veteran has familiar concepts and ready-made strategies to apply to a problem (Siegler, 2005). Given that the terrain is familiar, the expert expends less cognitive energy and is free to apply mental workspace to high-order activities such as metacognition (Flavell et al., 2002). Consider for a moment how a 6-year-old might respond to a cigarette advertisement in a magazine compared with how a 16-year-old would process the same message. The 6-year-old presumably has never smoked, has little knowledge of how the lungs work, is unaware of the legal battles being waged against the tobacco industry, is not cognizant of who paid for the placement of the ad in the magazine, and has little experience with the cost of various products in a grocery store. The teenager certainly has less experience than an adult would have in this domain, but compared with the grade schooler, the adolescent brings a much broader knowledge base from which to draw in interpreting and evaluating such an ad.

Increase in Processing Capacity. Regardless of age or level of development, all humans experience limits in the capacity of their working memory (Fougnie & Marois, 2006). In other words, certain situations and tasks are so demanding that they exceed a person’s available cognitive resources. One way this has been demonstrated is through reaction time studies that show that people perform slowly or poorly on secondary tasks when their mental energies are consumed by a primary task (Kail, 1991; Lang, 2000).

Developmental research demonstrates that as children mature, they are able to hold increasing amounts of information in working memory (Cowan,



Nugent, Elliott, Ponomarev, & Saults, 1999; Gathercole, 1998). For example, a 5-year-old is typically able to deal with only four or five bits of information at once (e.g., digits, letters), whereas the average adult can handle seven (Dempster, 1981). There are differing theoretical accounts for this increased processing capacity. Some have argued that the structure or size of one’s memory space actually increases with development (Cowan et al., 1999). Others have argued that the size remains fixed, but the functional use or efficiency of the space increases (Kail, 1993). As certain tasks become familiar, they are easily categorized into preexisting schemas. This categorization and routinization mean that fewer demands are placed on the cognitive system, and hence space is freed up for other cognitive processing.

Regardless of which view is correct, the implications are the same. Younger children have difficulty considering multiple pieces of information in working memory (see Figure 1.19). In addition, their capacities may be taxed quickly by a single cognitive activity that is somewhat novel and thus cannot be easily schematized. As children mature and gain experience in certain arenas, they can more quickly classify new information into preexisting schemas. This schematization allows them to consider and interrelate more bits of information at once and to engage in concurrent cognitive tasks. In other words, they become more efficient information processors.

How does processing capacity affect children’s interactions with the media? Research suggests that older children are better able than younger children to consider multiple cues within a scene or across several scenes when interpreting a television portrayal (Collins et al., 1974; Hoffner, Cantor, & Thorson, 1989). Likewise, older children are able to track the main plot of a television story even when there is a subplot interspersed throughout, whereas younger children’s comprehension suffers in the face of a distracting subplot (Weiss & Wilson, 1998). Older children are also better equipped to handle fast-paced programming that involves the integration of information across rapid changes in time and place (Wright et al., 1984). As discussed above, older children are also better able to consider their own thought processes while attending to a television program (Cantor & Wilson, 1984).

Any time a media message is complex, lengthy, fast paced, or delivered in a distracting environment, it is likely to present a cognitive challenge to younger children because of their more limited processing capacities.


Extending these ideas to online or digital technologies, we might also expect that interactive media such as fast-paced computer games will quickly tax the mental resources of a young child because of the need to simultaneously comprehend content and respond cognitively and physically to it. As processing capacity increases throughout childhood and adolescence, these once very difficult types of media interactions will become increasingly routinized.

Figure 1.19

SOURCE: Baby Blues © 2005 Baby Blues Partnership. Reprinted with permission of King Features Syndicate.

Infants and Baby Media Video products designed and marketed specifically for infants first appeared in the late 1990s, starting with the Baby Einstein series. Today, the marketplace is exploding with such products, including DVDs, websites, flashcards, and even video games. Parents eager to have their 6-month-old interact with new technologies can buy a Fisher-Price Laugh & Learn Smilin’ Smart Phone that activates music and fun phrases at the push of a button, or a VTech Baby’s Learning Laptop with a colorful keyboard and a movable mouse. There is even a TV network called BabyFirstTV that features round-the-clock programming for infants. Many of these products are marketed to parents who are keen to enhance the cognitive development of their very young children. Critics have charged that this “genius baby” industry is unfair and misleading (Linn, 2009). In fact, the company behind the Your Baby Can Read products recently announced it was going out of business, citing the high cost of legal battles it was fighting in trying to defend its advertising claims about helping infants to read (Crary, 2012).


As indicated earlier in this chapter, American babies do spend a fair amount of time with screen media—on average, about one and a half hours a day (Vandewater et al., 2007). Scholars have argued that several factors contribute to the rise in babies’ exposure to television and DVDs compared to a generation ago (Wartella, Richert, & Robb, 2010). First, families in the 21st century are accustomed to having television turned on throughout the day as a backdrop to all kinds of activities, including mealtimes. Obviously, this practice enhances exposure to screen media among children of all age groups. Second, families are moving older television sets into children’s rooms, including those of their infants. And third, parents today are more accustomed to sending young children to preschool, and anything that can better prepare their offspring for such educational experiences is likely to be attractive (see Figure 1.20).

Surveys indicate that many parents do indeed believe that videos and DVDs can foster their infants’ intellectual development (for a review, see Wartella et al., 2010). Yet the American Academy of Pediatrics (AAP) (2011) recently issued a recommendation that discourages media use for children younger than 2 years. The AAP also cautions against the use of background television intended for adults when an infant or baby is in the room. The AAP policy statement goes on to say, “Although infant/toddler programming might be entertaining, it should not marketed as or presumed by parents to be educational” (p. 4).

Figure 1.20 Babies with screen media.


Which view is accurate? Are media products good for infants or are they problematic? The research is still accumulating on this topic, but emerging findings suggest we need to be cautious about the educational merits of screen media for babies. For one thing, infants have difficulty orienting to the television screen and paying sustained visual attention to it until they are 3 to 6 months old (Courage & Setliff, 2010). Even after that, what captures their attention are salient cues such as laughter, music, peculiar sounds, and rapid character action (Valkenburg & Vroone, 2004). Clearly, the industry has figured this out in designing video content for babies. But paying attention to salient formal features on the screen does not mean that a baby comprehends the content (Courage & Setliff, 2010).

In fact, there are a growing number of studies indicating that before the age of roughly 3, babies learn better from watching a live person than from watching the same type of material enacted on television (see Barr, 2010). This phenomenon has been called the “video deficit” effect (Anderson & Pempek, 2005), and it has been demonstrated for a range of activities, such as teaching infants to imitate novel behaviors, search for a hidden object, and respond to emotional cues (Barr, 2010). The superiority of live action over TV is likely due to several factors, including younger children’s difficulty in translating information from a two-dimensional to a three- dimensional format and their difficulty in appreciating the symbolic nature of what is on the screen (Barr, 2010).

Nevertheless, by about 18 months of age, babies are capable of learning some things from screen media, including simple vocabulary (Vandewater, 2011) and novel action sequences (Simcock, Garrity, & Barr, 2011). However, such learning is more apt to occur under the following conditions:

• when the video material is repeatedly viewed (Barr, Muentener, Garcia, Fujimoto, & Chavez, 2007)

• when popular characters are used (Lauricella, Gola, & Calvert, 2011)

• when an adult is in the room reinforcing the material (Barr, Zack, Garcia, & Muentener, 2008)

• when the material is developmentally appropriate (Linebarger & Walker, 2005)

Given all of these caveats, one might argue that spending time interacting with family members is better for babies than being plopped down in front of a screen. Indeed, developmental psychologists long have held that babies


need rich social interactions with caregivers in order for healthy development to occur. Even in this context, screen media can be a challenge. Research shows that parents are less likely to interact with their babies when the television is turned on in the background (Christakis et al., 2009), and babies themselves spend less time playing with toys when the television is turned on compared to when it is off (Schmidt, Pempek, Kirkorian, Lund, & Anderson, 2008). As we develop more sophisticated ways of assessing brain development in babies, surely screen media will factor in to how we understand their growth.

Conclusion The purpose of this chapter has been to underscore the fact that children are very different from adults and from each other when they interact with the media. Children are eager to learn, have less real-world experience, and have less developed cognitive skills, making them ultimately more vulnerable to media messages. The remainder of this book will explore how children and teens respond to different types of media content, such as violence and sexual messages, as well as to different media technologies, such as video games and the Internet. We will continually draw on the concepts and developmental trends presented in this chapter to explain how children deal with the stimulating media world that confronts them. Clearly, there are robust developmental differences in children’s attention to and comprehension of media messages. These cognitive processes in turn have implications for emotional responding as well as behavioral reactions to the media.

Exercises 1. Think about your childhood. What is the first experience you

remember having with the media? How old were you? What medium was involved? What type of content was involved? What was your reaction or response to the experience? Did your parents know about it? Could a child today have a similar experience? Why or why not?

2. For one day, chart the time you spend with the media (e.g., television, radio, books, cell phone, Internet). Note which media you are using and what type of content you are experiencing. Also note when you


are “media multitasking,” or using two or more media at once (e.g., reading a book and listening to music). How much of your day did you spend with the media? Is your media use similar to that of the typical American child, as described in this chapter? How is it similar and how is it different? Do you perceive that you are effective or ineffective when media multitasking? Provide justification for your response.

3. Watch an episode of a TV sitcom that is popular with children. Think about the main theme of the program, the sequence of events in the storyline, and the nature of the characters. Based on developmental differences in cognitive processing, describe three ways in which a 4-year-old’s interpretation of the episode would differ from that of a 10-year-old. How would a 10-year-old’s interpretation differ from that of a teenager? What type of viewer do you think the program is targeted toward? Think about the program itself as well as the commercial breaks in addressing this question.

4. Some scholars argue that childhood is disappearing in today’s modern society. They maintain that children are dressing more like adults, talking like them, and experiencing adult activities and even adult media content. Can you think of examples to support this thesis? Can you think of examples that challenge it? How is childhood changing in the 21st century? Do you agree that childhood is vanishing? How crucial are the media in debates about these issues?

5. When you were a child, did your parents have rules about what you could do with the mass media? Did they have rules when you were a teenager? Did you have a TV set in your bedroom? Do you think parents should exercise control over their children’s media experiences? Why or why not?

6. Compare and contrast three rating systems designed to inform parents about media content: (a) the Motion Picture Association of America’s ratings for movies (see rating-means), (b) the TV Parental Guidelines for television shows (see, and (c) the Entertainment Software Rating Board’s ratings for computer and video games (see Evaluate the three systems in terms of what we know about child development, as discussed in this chapter. Do the systems seem accurate? Are they likely to be helpful to parents? How could they be improved? Can you think of a movie, TV show, or video game that you think is rated


inappropriately? 7. Watch a program targeted to children that airs on public broadcasting

(e.g., Sesame Street, Arthur, WordGirl). Now compare it with a cartoon that airs on Cartoon Network, ABC Kids, or Nickelodeon. Compare and contrast the two programs in terms of plot, characters, formal features, and degree of realism. Which program seems better suited to the developmental capabilities of a 4- or 5-year-old? Why?

8. Find the lyrics to a song from a genre of music that is popular among young people today (e.g., hip-hop, rap). Now compare the lyrics to those from a Beatles’ song of the 1960s or 1970s. What do the songs say about adolescence? How are the songs similar in their representation of adolescent themes such as risk taking, social identity, peer relations, and sexuality? How are they different? Think about the social and political context in which these songs were written in addressing these issues.

9. Are you surprised by the amount of time that babies spend with media each day? What do you think about the AAP guidelines that discourage media use for children under the age of 2? Are the guidelines reasonable? Are they based on sound evidence? Should companies in the U.S. be allowed to market media products to very young children? Why or why not?


Ackerman, B. P. (1988). Reason inferences in the story comprehension of children and adults. Child Development, 59, 1426–1442.

Adler, J. (1999, May 10). Beyond Littleton: The truth about high school. Newsweek, pp. 56–58.

Alexander, K. J., Miller, P. J., & Hengst, J. A. (2001). Young children’s emotional attachments to stories. Social Development, 10(3), 374–398.

American Academy of Pediatrics, Council on Communications and Media. (2011). Media use by children younger than 2 years. Pediatrics, 128(5), 1–6.

American Kids Study. (2010, January 4). Kids’ cell phone ownership has dramatically increased in past five years. Retrieved from

Anderson, D. R., & Levin, S. R. (1976). Young children’s attention to


Sesame Street. Child Development, 47, 806–811. Anderson, D. R., & Pempek, T. A. (2005). Television and very young

children. American Behavioral Scientist, 48(5), 505–522. Archibald, A. B., Graber, J. A., & Brooks-Gunn, J. (2003). Pubertal

processes and physiological growth in adolescence. In G. R. Adams & M. D. Berzonsky (Eds.), Blackwell handbook of adolescence (pp. 24– 47). Malden, MA: Blackwell.

Arnett, J. J. (1992a). Reckless behavior in adolescence: A developmental perspective. Developmental Review, 12, 339–373.

Arnett, J. J. (1992b). Socialization and adolescent reckless behavior: A reply to Jessor. Developmental Review, 12, 391–409.

Arnett, J. J. (1995). Broad and narrow socialization: The family in the context of a cultural theory. Journal of Marriage and Family, 57(3), 617–628.

Arnett, J. J. (1999). Adolescent storm and stress, reconsidered. American Psychologist, 54(5), 317–326.

Arnett, J. J. (2007). Emerging adulthood: What is it, and what is it good for? Child Development Perspectives, 1(2), 68–73.

Babey, S. H., Hastert, T. A., & Wolstein, J. (2013). Adolescent sedentary behaviors: Correlates differ for television viewing and computer use. Journal of Adolescent Health, 52, 70-76.

Baldas, T. (2012, May 28). Dander in the chat room: More kids vulnerable to sexual exploits online. Detroit Free Press. Retrieved from

Barr, R. (2010). Transfer of learning between 2D and 3D sources during infancy: Informing theory and practice. Developmental Review, 30, 128– 154.

Barr, R., Muentener, R., Garcia, A., Fujimoto, M., & Chavez, V. (2007). The effect of repetition on imitation from television during infancy. Developmental Psychology, 49, 196–207.

Barr, R., Zack, E., Garcia, A., & Muentener, P. (2008). Infants’ attention and responsiveness to television increases with prior exposure and parental interaction. Infancy, 13, 30–56.

Beentjes, J., deKoning, E., & Huysmans, F. (2001). Children’s comprehension of visual formal features in television programs. Journal of Applied Developmental Psychology, 22(6), 623–638.

Berk, L. E. (2000). Child development (5th ed.). Boston, MA: Allyn & Bacon.


Bickham, D. S., Wright, J. C., & Huston, A. C. (2001). Attention, comprehension, and the educational influences of television. In D. G. Singer & J. L. Singer (Eds.), Handbook of children and the media (pp. 101–119). Thousand Oaks, CA: Sage.

Bowman, L. L., Levine, L. E., Waite, B. M., & Gendron, M. (2010). Can students really multitask? An experimental study of instant messaging while reading. Computers and Education, 54(4), 927–931.

Brown, J. D., Halpern, C. T., & L’Engle, K. L. (2005). Mass media as a sexual super peer for early maturing girls. Journal of Adolescent Health, 36, 420–427.

Brown, M. H., Skeen, P., & Osborn, D. K. (1979). Young children’s perception of the reality of television. Contemporary Education, 50, 129–133.

Bruner, J. S. (1966). On cognitive growth (I & II). In J. S. Bruner, R. R. Olver, & P. M. Greenfield (Eds.), Studies in cognitive growth (pp. 1– 67). New York, NY: John Wiley.

Bruner, J. S., Olver, R., & Greenfield, P. (1966). Studies in cognitive growth. New York, NY: John Wiley.

Buckingham, D. (2000). After the death of childhood: Growing up in the age of electronic media. Cambridge, UK: Polity.

Buckingham, D. (2011). The material child: Growing up in consumer culture. Cambridge, UK: Polity.

Bussey, K., & Bandura, A. (1999). Social cognitive theory of gender development and differentiation. Psychological Review, 106, 676–713.

Byrnes, J. P. (2003). Cognitive development during adolescence. In G. R. Adams & M. D. Berzonsky (Eds.), Blackwell handbook of adolescence (pp. 227–246). Malden, MA: Blackwell.

Calvert, S. L. (1999). Children’s journeys through the information age. Boston, MA: McGraw-Hill.

Calvert, S. L., & Gersh, T. L. (1987). The selective use of sound effects and visual inserts for children’s story comprehension. Journal of Applied Developmental Psychology, 8, 363–374.

Calvert, S. L., Huston, A. C., Watkins, B. A., & Wright, J. C. (1982). The relations between selective attention to television forms and children’s comprehension of content. Child Development, 53, 601–610.

Campbell, T. A., Wright, J. C., & Huston, A. C. (1987). Form cues and content difficulty as determinants of children’s cognitive processing of televised educational messages. Journal of Experimental Child


Psychology, 43, 311–327. Campos, L. A., & Barret, K. C. (1984). Toward a new understanding of

emotions and their development. In C. E. Izard & R. B. Zajonc (Eds.), Emotion, cognition, and behavior (pp. 229–263). Cambridge, UK: Cambridge University Press.

Cantor, J. (1998). “Mommy, I’m scared”: How TV and movies frighten children and what we can do to protect them. San Diego, CA: Harcourt Brace.

Cantor, J. (2009). Conquer cyberoverload: Get more done, boost your creativity, and reduce stress. Madison, WI: CyberOutlook Press.

Cantor, J., & Wilson, B. J. (1984). Modifying fear responses to mass media in preschool and elementary school children. Journal of Broadcasting, 28, 431–443.

Carlsson, U. (2010). Young people in the digital media culture: Global and Nordic perspectives: An introduction. In U. Carlsson (Ed.), Children and youth in the digital media culture: From a Nordic horizon (pp. 9–22). Goteborg, Sweden: Nordicom.

Carr, D. (2007, March 29). Do they still want their MTV? New York Times. Retrieved from

Centers for Disease Control and Prevention. (2011). Teenagers in the United States: Sexual activity, contraceptive use, and childbearing, 2006–2010 national survey on family growth. Vital and Health Statistics, 23(31). Retrieved June 16, 2012, from

Centers for Disease Control and Prevention. (2012, July 27). Trends in HIV-related risk behaviors among high school students – United States, 1991–2001. Retrieved from s_cid=mm6129a4_w

Chan, K. (2001). Children’s perceived truthfulness of television advertising and parental influence: A Hong Kong study. Advances in Consumer Research, 28, 207–212.

Christakis, D. A., Gilkerson, J., Richards, J. A., Zimmerman, F. J., Garrison, M. M., Xu, D., . . . Yapanel, U. (2009). Audible television and decreased adult words, infant vocalizations, and conversational turns: A population- based study. Archives of Pediatrics and Adolescent Medicine, 163(6), 554–558.


Claxton, L. J., & Ponto, K. C. (2013). Understanding the properties of interactive characters. Journal of Applied Developmental Psychology,

Collins, W. A. (1983). Interpretation and inference in children’s television viewing. In J. Bryant & D. R. Anderson (Eds.), Children’s understanding of television (pp. 125–150). New York, NY: Academic Press.

Collins, W. A., Berndt, T. J., & Hess, V. L. (1974). Observational learning of motives and consequences for television aggression: A developmental study. Child Development, 45, 799–802.

Collins, W. A., Wellman, H., Keniston, A., & Westby, S. (1978). Age- related aspects of comprehension and inference from a televised dramatic narrative. Child Development, 49, 389–399.

Cookston, J. T., & Finlay, A. K. (2006). Father involvement and adolescent adjustment: Longitudinal findings from Add Health. Fathering: A Journal of Theory, Research, and Practice About Men as Fathers, 4(2), 137– 158.

Courage, M. L., & Setliff, A. E. (2010). When babies watch television: Attention getting, attention holding, and implications for learning. Developmental Review, 30, 220–238.

Cowan, N., Nugent, L. D., Elliott, E. M., Ponomarev, I., & Saults, J. S. (1999). The role of attention in the development of short-term memory: Age differences in the verbal span of apprehension. Child Development, 70, 1082–1097.

Crary, D. (2012, June 16). Your Baby Can Read company going out of business. Huffington Post. Retrieved from read_n_1677465.html

Creemers, H. E., Korhonen, T., Kaprio, J., Vollebergh, W. A. M., Ormel, J., Verhulst, F. C., & Huizink, A. C. (2009). The role of temperament in the relationship between early onset of tobacco and cannabis use: The TRAILS study. Drug and Alcohol Dependence, 104, 113–118.

Crosnoe, R., & Johnson, M. K. (2011). Research on adolescence in the twenty-first century. Annual Review of Sociology, 37, 439–460.

Davis, K. (2010). Coming of age online: The developmental underpinnings of girls’ blogs. Journal of Adolescent Research, 25(1), 145–171.

Dempster, F. N. (1981). Memory span: Sources of individual and developmental differences. Psychological Bulletin, 89, 63–100.

Dishion, T. J. (1990). The family ecology of boys’ peer relations in middle


childhood. Child Development, 61, 874–892. Dorr, A. (1980). When I was a child, I thought as a child. In S. B. Withey &

P. P. Abeles (Eds.), Television and social behavior: Beyond violence and children (pp. 191–230). Hillsdale, NJ: Lawrence Erlbaum.

Dorr, A. (1983). No shortcuts to judging reality. In J. Bryant & D. R. Anderson (Eds.), Children’s understanding of television (pp. 199–220). New York, NY: Academic Press.

Dorr, A. (1986). Television and children: A special medium for a special audience. Thousand Oaks, CA: Sage.

Durkin, K., & Lowe, P. J. (1999). The effect of flashback on children’s understanding of television crime content. Journal of Broadcasting and Electronic Media, 43(1), 83–97.

Eaton, W. O., & Enns, L. R. (1986). Sex differences in human motor activity level. Psychological Bulletin, 100, 19–28.

Eisenberg, N., Fabes, R. A., & Spinrad, T. L. (2006). Prosocial development. In N. Eisenberg, W. Damon, & R. M. Lerner (Eds.), Handbook of child psychology: Vol. 3. Social, emotional, and personality development (pp. 646–718). Hoboken, NJ: John Wiley.

Elkind, D. (1967). Egocentrism in adolescence. Child Development, 38, 1025–1034.

Elkind, D. (1985). Egocentrism redux. Developmental Review, 5, 218–226. Eveland, W. P., Nathanson, A. I., Detenber, A. I., & McLeod, D. M. (1999).

Rethinking the social distance corollary: Perceived likelihood of exposure and the third-person perception. Communication Research, 26, 275–302.

Feeling good about visiting the doctor. (1996). Research Roundup, 5, 1. Feng, J., Spence, I., & Pratt, J. (2007). Playing an action video game

reduces gender difference in spatial cognition. Psychological Science, 18, 850–855.

Finn, P., & Bragg, B. W. (1986). Perception of risk of an accident by young and older drivers. Accident Analysis and Prevention, 18, 289–298.

Fiske, S. T., & Taylor, S. E. (1991). Social cognition (2nd ed.). New York, NY: McGraw-Hill.

Flavell, J. H., Flavell, E. R., Green, F. L., & Korfmacher, J. E. (1990). Do young children think of television images as pictures or real objects? Journal of Broadcasting and Electronic Media, 34, 399–417.

Flavell, J. H., Friedrichs, A. G., & Hoyt, J. (1970). Developmental changes


in memorization processes. Cognitive Psychology, 1, 324–340. Flavell, J. H., Miller, P. H., & Miller, S. A. (2002). Cognitive development

(4th ed.). Englewood Cliffs, NJ: Prentice Hall. Fougnie, D., & Marois, R. (2006). Distinct capacity limits for attention and

working memory: Evidence from attentive tracking and visual working memory paradigms. Psychological Science, 17, 526–534.

Fulkerson, J. A., Story, M., Mellin, A., Leffert, N., Neumark-Sztainer, D., & French, S. A. (2006). Family dinner meal frequency and adolescent development: Relationships with developmental assets and high-risk behaviors. Journal of Adolescent Health, 39, 337–345.

Garrison, M. M., Liekweg, K., & Christakis, D. A. (2011). Media use and child sleep: The impact of content, timing, and environment. Pediatrics, 128(1), 29–35.

Gathercole, S. E. (1998). The development of memory. Journal of Child Psychology and Psychiatry, 39(1), 3–27.

Gauffroy, C., & Barrouillet, P. (2011). The primacy of thinking about possibilities in the development of reasoning. Developmental Psychology, 47(4), 1000–1011.

Gentile, D. A., Nathanson, A. I., Rasmussen, E. E., Reimer, R. A., & Walsh, D. A. (2012). Do you see what I see? Parent and child reports of parental monitoring of media. Family Relations, 61(3), 470–487.

Gerrard, M., McCann, L., & Fortini, M. (1983). Prevention of unwanted pregnancy. American Journal of Community Psychology, 11, 153–167.

Ginsburg, H., & Opper, S. (1979). Piaget’s theory of intellectual development (2nd ed.). Englewood Cliffs, NJ: Prentice Hall.

Gondoli, D. M. (1999). Adolescent development and health. In T. L. Whitman, T. V. Merluzzi, & R. D. White (Eds.), Life-span perspectives on health and illness (pp. 147–163). Mahwah, NJ: Lawrence Erlbaum.

Graber, J. A., Brooks-Gunn, J., & Petersen, A. C. (Eds.). (1996). Transitions through adolescence: Interpersonal domains and context. Mahwah, NJ: Lawrence Erlbaum.

Greene, K., Krcmar, M., Walters, L. H., Rubin, D. L., & Hale, J. (2000). Targeting adolescent risk-taking behaviors: The contributions of egocentrism and sensation-seeking. Journal of Adolescence, 23, 439– 461.

Greenfield, P. M., Bruzzone, L., Koyamatsu, K., Satuloff, W., Nixon, K., Brodie, M., & Kingsdale, D. (1987). What is rock music doing to the minds of our youth? A first experimental look at the effects of rock music


lyrics and music videos. Journal of Early Adolescence, 7, 315–329. Greenfield, P. M., deWinstanley, P., Kilpatrick, H., & Kaye, D. (1996).

Action video games and informal education: Effects on strategies for dividing visual attention. In P. M. Greenfield & R. R. Cocking (Eds.), Interacting with video (pp. 187–205). Norwood, NJ: Ablex.

Groebel, J. (1999). Media access and media use among 12-year-olds in the world. In C. von Feilitzen & U. Carlsson (Eds.), Children and media: Image, education, participation (pp. 61–68). Goteborg, Sweden: UNESCO International Clearinghouse on Children and Violence on the Screen.

Grossberg, L., Wartella, E., & Whitney, D. C. (1998). Media making: Mass media in a popular culture. Thousand Oaks, CA: Sage.

Halpern, D. F. (2004). A cognitive-process taxonomy for sex differences in cognitive abilities. Current Directions in Psychological Science, 13(4), 135–139.

Harris, J. R. (1998). The nurture assumption: Why children turn out the way they do. New York, NY: Free Press.

Harrison, K., & Cantor, J. (1999). Tales from the screen: Enduring fright reactions to scary media. Media Psychology, 1, 97–116.

Hartup, W. W., & Stevens, N. (1997). Friendships and adaptation in the life course. Psychological Bulletin, 121, 355–370.

Hawkins, R. P. (1977). The dimensional structure of children’s perceptions of television reality. Communication Research, 7, 193–226.

Haynie, D. L. (2002). Friendship networks and delinquency: The relative nature of peer delinquency. Journal of Quantitative Criminology, 18(2), 99–134.

Hiltzik, M. (2011, January 1). Comcast-NBC merger does nothing to enhance the public interest. Los Angeles Times. Retrieved from

Hoekstra, S. J., Harris, R. J., & Helmick, A. L. (1999). Autobiographical memories about the experience of seeing frightening movies in childhood. Media Psychology, 1, 117–140.

Hoffner, C., & Cantor, J. (1985). Developmental difference in responses to a television character’s appearance and behavior. Developmental Psychology, 21, 1065–1074.

Hoffner, C., Cantor, J., & Badzinski, D. M. (1990). Children’s understanding of adverbs denoting degree of likelihood. Journal of Child Language, 17, 217–231.


Hoffner, C., Cantor, J., & Thorson, E. (1989). Children’s responses to conflicting auditory and visual features of a televised narrative. Human Communication Research, 16, 256–278.

Hudson, J. A., Sosa, B. B., & Shapiro, L. R. (1997). Scripts and plans: The development of preschool children’s event knowledge and event planning. In S. L. Friedman & E. K. Scholnick (Eds.), The developmental psychology of planning: Why, how, and when do we plan? (pp. 77–102). Mahwah, NJ: Lawrence Erlbaum.

Huston, A. C., & Wright, J. C. (1983). Children’s processing of television: The informative functions of formal features. In J. Bryant & D. R. Anderson (Eds.), Children’s understanding of television: Research on attention and comprehension (pp. 35–68). New York, NY: Academic Press.

Jaglom, L. M., & Gardner, H. (1981). The preschool television viewer as anthropologist. In H. Kelly & H. Gardner (Eds.), New directions for child development: Viewing children through television (pp. 9–30). San Francisco, CA: Jossey-Bass.

James, A., Allison, J., Jenks, C., & Prout, A. (1998). Theorizing childhood. New York, NY: Teachers College Press.

Jessor, R. (1992). Risk behavior in adolescence: A psychosocial framework for understanding and action. Developmental Review, 12, 374–390.

Jochen, P., Valkenburg, P. M., & Schouten, A. P. (2006). Characteristics and motives of adolescents talking with strangers on the internet. CyberPsychology and Behavior, 9(5), 526–530.

Jordan, A., Bleakley, A., Manganello, J., Hennessy, M., Steven, R., & Fishbein, M. (2010). The role of television access in the viewing time of US adolescents. Journal of Children and Media, 4(4), 355–370.

Kagan, J., & Snidman, N. C. (2004). The long shadow of temperament. Cambridge, MA: Harvard University Press.

Kail, R. (1991). Developmental changes in speed of processing during childhood and adolescence. Psychological Bulletin, 109, 490–501.

Kail, R. (1993). The role of a global mechanism in developmental change in speed of processing. In M. L. Howe & R. Pasnak (Eds.), Emerging themes in cognitive development, Vol. 1: Foundations (pp. 97–119). New York, NY: Springer-Verlag.

Keating, D. P. (2004). Cognitive and brain development. In R. M. Lerner & L. Steinberg (Eds.), Handbook of adolescent psychology (2nd ed., pp. 45–84). Hoboken, NJ: John Wiley.


Kendeou, P., Bohn-Gettler, C., White, M., & van den Broek, P. (2008). Children’s inference generation across different media. Journal of Research in Reading, 31(3), 259–272.

Kistner, J., Counts-Allan, C., Dunkel, S., Drew, C.H., David-Ferdon, C., & Lopez, C. (2010). Sex differences in relational and overt aggression in the late elementary school years. Aggressive Behavior, 36(5), 282–291.

Klimstra, T. A., Hale, W. W., Raaijmakers, Q. A. W., Branje, S. J. T., & Meeus, W. H. J. (2010). Identity formation in adolescence: Change or stability? Journal of Youth and Adolescence, 39(2), 150–162.

Lang, A. (2000). The limited capacity model of mediated message processing. Journal of Communication, 50(1), 46–70.

Larson, R., Richards, M. H., Moneta, G., Holmbeck, G., & Duckett, E. (1996). Changes in adolescents’ daily interactions with their families from ages 10 to 18: Disengagement and transformation. Developmental Psychology, 32, 744–754.

Lauricella, A. R., Gola, A. A. H., & Calvert, S. (2011). Toddlers’ learning from socially meaningful video characters. Media Psychology, 14, 216– 232.

Lemish, D. (1987). Viewers in diapers: The early development of television viewing. In T. R. Lindlof (Ed.), Natural audiences: Qualitative research of media uses and effects (pp. 33–57). Norwood, NJ: Ablex.

Lenhart, A. (2012). Teens, smartphones, & texting. Retrieved from

Linebarger, D. L., & Walker, D. (2005). Infants’ and toddlers’ television viewing and language outcomes. American Behavioral Scientist, 48, 624–645.

Linn, S. (2009). The case for make believe: Saving play in a commercialized world. New York, NY: New Press.

Livingstone, S. (2002). Young people and new media: Childhood and the changing media environment. Thousand Oaks, CA: Sage.

Lorch, E. P., Bellack, D. R., & Augsbach, L. H. (1987). Young children’s memory for televised stories: Effects of importance. Child Development, 58, 453–463.

Lovett, S. B., & Flavell, J. H. (1990). Understanding and remembering: Children’s knowledge about the differential effects of strategy and task variables on comprehension and memorization. Child Development, 61, 1842–1858.

Mandler, J. M. (1998). Representation. In W. Damon (Series Ed.) & D.


Kuhn & R. Siegler (Vol. Eds.), Handbook of child psychology: Vol. 2. Cognition, perception, and language (pp. 255–308). New York, NY: John Wiley.

Mares, M. L., & Acosta, E. E. (2008). Be kind to three-legged dogs: Children’s literal interpretations of TV’s moral lessons. Media Psychology, 11, 377–399.

Meadowcroft, J. M., & Reeves, B. (1989). Influence of story scheme development on children’s attention to television. Communication Research, 16, 352–374.

Melkman, R., Tversky, B., & Baratz, D. (1981). Developmental trends in the use of perceptual and conceptual attributes in grouping, clustering, and retrieval. Journal of Experimental Child Development, 31, 470–486.

Metcalfe, J., & Shimamura, A. P. (Eds.). (1994). Metacognition: Knowing about knowing. Cambridge, MA: MIT Press.

Morison, P., Kelly, H., & Gardner, H. (1981). Reasoning about the realities of television: A developmental study. Journal of Broadcasting, 25, 229– 242.

Moshman, D. (1998). Cognitive development beyond childhood. In W. Damon (Series Ed.) & D. Kuhn & R. Siegler (Vol. Eds.), Handbook of child psychology: Vol. 2. Cognition, perception, and language (5th ed., pp. 947–978). New York, NY: John Wiley.

National Survey on Drug Use and Health. (2010). Results from the 2010 National Survey on Drug Use and Health: Summary of national findings. Retrieved from

Noble, G. (1975). Children in front of the small screen. Thousand Oaks, CA: Sage.

O’Bryan, K. G., & Boersma, F. J. (1971). Eye movements, perceptual activity, and conservation development. Journal of Experimental Child Psychology, 12, 157–169.

Owens, J. M., McLaughlin, S. B., & Sudweeks, J. (2011). Driver performance while text messaging using handheld and in-vehicle systems. Accident Analysis and Prevention, 43(3), 939–947.

Paradise, A., & Sullivan, M. (2012). (In)visible threats? The third-person effect in perceptions of the influence of Facebook. Cyberpsychology, Behavior, and Social Networking, 15(1), 55–60.

Perloff, R. M. (2009). Mass media, social perception, and the third-person effect. In J. Bryant & M. B. Oliver (Eds.), Media effects: Advances in


theory and research (pp. 252–268). New York, NY: Routledge. Petersen, A. C., & Taylor, B. (1980). The biological approach to

adolescence: Biological change and psychological adaptation. In J. Adelson (Ed.), Handbook of adolescent psychology (pp. 117–155). New York, NY: John Wiley.

Pharo, H., Sim, C., Graham, M., Gross, J., & Hayne, H. (2011). Risky business: Executive function, personality, and reckless behavior during adolescence and emerging adulthood. Behavioral Neuroscience, 125(6), 970–978.

Piaget, J. (1930). The child’s conception of the world. New York, NY: Harcourt, Brace & World.

Piaget, J. (1950). The psychology of intelligence. New York, NY: International Universities Press.

Piaget, J. (1952). The origins of intelligence in children. New York, NY: International Universities Press.

Piaget, J., & Inhelder, B. (1975). The origin of the idea of chance in children. New York, NY: W.W. Norton.

Pike, M. M., Barnes, M. A., & Barron, R. W. (2010). The role of illustrations in children’s inferential comprehension. Journal of Experimental Child Psychology, 105(3), 243–255.

Potter, W. J. (2010). The state of media literacy. Journal of Broadcasting and Electronic Media, 54(4), 675–696.

Public Agenda. (1999). Kids these days ‘99: What Americans really think about the next generation. Retrieved from

Rekers, G. A. (1992). Development of problems of puberty and sex roles in adolescence. In C. E. Walker & M. C. Roberts (Eds.), Handbook of clinical child psychology (pp. 607–622). New York, NY: John Wiley.

Resnick, M. D., Bearman, P. S., Blum, R. W., Bauman, K. E., Harris, K. M., Jones, J., . . . Udry, J. R. (1997). Protecting adolescents from harm: Findings from the national longitudinal study on adolescent health. Journal of the American Medical Association, 278, 823–832.

Revelle, G. L., Medoff, L., & Strommen, E. F. (2001). Interactive technologies research at the Children’s Television Workshop. In S. M. Fisch & R. T. Truglio (Eds.), “G” is for growing: Thirty years of research on Sesame Street (pp. 215–230). Mahwah, NJ: Lawrence Erlbaum.

Rideout, V. J. (2012). Social media, social life: How teens view their


digital lives. Retrieved from

Rideout, V. J., Foehr, U. G., & Roberts, D. F. (2010). Generation M2: Media in the lives of 8- to 18-year-olds. Menlo Park, CA: Kaiser Family Foundation.

Rideout, V., & Hamel, E. (2006). The media family: Electronic media in the lives of infants, toddlers, preschoolers and their parents. Menlo Park, CA: Kaiser Family Foundation.

Rideout, V., Lauricella, A., & Wartella, E. (2011). Children, media, and race: Media use among white, black, Hispanic and Asian American children. Retrieved from content/uploads/2011/06/SOCconfReportSingleFinal-1.pdf

Roth, J., & Brooks-Gunn, J. (2000). What do adolescents need for healthy development? Implications for youth policy. Social Policy Report, 14, 3– 19.

Rubin, K. H., Bukowski, W., & Parker, J. G. (2006). Peer interactions, relationships, and groups. In W. Damon & N. Eisenberg (Eds.), Handbook of child psychology: Social, emotional, and personality development (5th ed., pp. 619–700). Hoboken, NJ: John Wiley.

Ruble, D. N., Taylor, L. J., Cyphers, L., Greulich, F. K., Lurye, L. E., & Shrout, P. E. (2007). The role of gender constancy in early gender development. Child Development, 78(4), 1121–1136.

Salomon, G. (1983). Television watching and mental effort: A social psychological view. In J. Bryant & D. R. Anderson (Eds.), Children’s understanding of television: Research on attention and comprehension (pp. 181–198). New York, NY: Academic Press.

Salomon, G., & Leigh, T. (1984). Predispositions about learning from print and television. Journal of Communication, 34(2), 119–135.

Santelli, J., Carter, M., Orr, M., & Dittus, P. (2009). Trends in sexual risk behaviors, by nonsexual risk behavior involvement, U.S. high school students, 1991–2007. Journal of Adolescent Health, 44(4), 372–379.

Scherrer, J. F., Xian, H., Pan, H., Pergadia, M. L., Madden, P. A., Grant, J. D., Sartor, C. E., . . . Bucholz, K. K. (2012). Parent, sibling and peer influences on smoking initiation, regular smoking and nicotine dependence: Results from a genetically informative design. Addictive Behavior, 37(3), 240–247.

Schmidt, M. E., Pempek, T. A., Kirkorian, H. L., Lund, A. F., & Anderson, D. R. (2008). The effect of background television on the toy play


behavior of very young children. Child Development, 79, 1137–1151. Schmitt, K. L., Anderson, D. R., & Collins, P. A. (1999). Form and content:

Looking at visual features of television. Developmental Psychology, 35, 1156–1167.

Scholz, R. W., & Waller, M. (1983). Conceptual and theoretical issues in developmental research on the acquisition of the probability concept. In R. W. Scholz (Ed.), Decision making under uncertainty (pp. 291–311). New York, NY: North Holland.

Schwartz, P. D., Maynard, A. M., & Uzelac, S. M. (2008). Adolescent egocentrism: A contemporary view. Adolescence, 43, 441–448.

Siegler, R. S. (2005). Children’s learning. American Psychologist, 60, 769– 778.

Silver, J. (2011, January 18). Comcastrophe: Comcast/NBC merger approved. Huffington Post. Retrieved from m_b_810380.html

Simcock, G., Garrity, K., & Barr, R. (2011). The effect of narrative cues on infants’ imitation from television and picture books. Child Development, 82(5), 1607–1619.

Smith, R., Anderson, D. R., & Fischer, C. (1985). Young children’s comprehension of montage. Child Development, 56, 962–971.

Song, A. V., Glantz, S. A., Halpern-Felsher, B. L. (2009). Perceptions of second-hand smoke risks predict future adolescent smoking initiation. Journal of Adolescent health, 45(6), 618–625.

Sowell, E. R., Trauner, D. A., Gamst, A., & Jernigan, T. L. (2002). Development of cortical and subcortical brain structures in childhood and adolescence: A structural MRI study. Developmental Medicine and Child Neurology, 44(1), 4–16.

Sparks, G. G. (1986). Developmental difference in children’s reports of fear induced by the mass media. Child Study Journal, 16, 55–66.

Spear, L. P. (2010). Behavioral neuroscience of adolescence. New York, NY: W. W. Norton.

Springer, K. (2001). Perceptual boundedness and perceptual support in conceptual development. Psychological Review, 108(4), 691–708.

Stegge, H., & Terwogt, M. M. (2007). Awareness and regulation of emotion in typical and atypical development. In J. J. Gross (Ed.), Handbook of emotion regulation (pp. 269–286). New York, NY: Guilford.

Steinberg, L. (2005). Cognitive and affective development in adolescence.


Trends in Cognitive Sciences, 9(2), 69–74. Steyer, J. P. (2002). The other parent: The inside story of the media’s

effect on our children. New York, NY: Atria Books. Subrahmanyam, K., & Greenfield, P. (2008). Media symbol systems and

cognitive processes. In S. Calvert & B. J. Wilson (Eds.), The Blackwell handbook of children, media, and development (pp. 166–187). London, UK: Blackwell.

Tversky, B. (1985). Development of taxonomic organization of named and pictured categories. Developmental Psychology, 21, 1111–1119.

Valkenburg, P., & Peter, J. (2011). Online communication among adolescents: An integrated model of its attraction, opportunities, and risks. Journal of Adolescent Health, 48(2), 121–127.

Valkenburg, P., Schouten, A., & Peter, J. (2005). Adolescents’ identity experiments on the Internet. New Media and Society, 7(3), 383–402.

Valkenburg, P., & Vroone, M. (2004). Developmental changes in infants’ and toddlers’ attention to television entertainment. Communication Research, 31(1), 288–311.

van den Broek, P., Lorch, E. P., & Thurlow, R. (1996). Children’s and adults’ memory for television stories: The role of causal factors, story- grammar categories, and hierarchical level. Child Development, 67, 3010–3028.

Vandewater, E. A. (2011). Infant word learning from commercially available video in the US. Journal of Children and Media, 5(3), 248– 266.

Vandewater, E. A., Rideout, V. J., Wartella, E. A., Huang, X., Lee, J. H., & Shim, M. (2007). Digital childhood: Electronic media and technology use among infants, toddlers and preschoolers. Pediatrics, 119, e1006–e1015. Retrieved from

Vidmar, N., & Rokeach, M. (1974). Archie Bunker’s bigotry: A study in selective perception and exposure. Journal of Communication, 24(1), 36–47.

Walsh-Childers, K. (1997). A content analysis: Sexual coverage in women’s, men’s, teen and other specialty magazines. Menlo Park, CA: Kaiser Family Foundation.

Wartella, E., & Reeves, B. (1985). Historical trends in research on children and the media: 1900–1960. Journal of Communication, 35(2), 118–132.

Wartella, E., Richert, R. A., & Robb, M. B. (2010). Babies, television, and videos: How did we get here? Developmental Review, 30, 116–127.


Watson, J. M., Lambert, A. E., Miller, A. E., & Strayer, D L. (2011). The magical letters P, F, C, and sometimes U: The rise and fall of executive attention with the development of prefrontal cortex. In K. L. Fingerman, C. A. Berg, J. Smith, & T. C. Antonucci (Eds.), Handbook of life-span development (pp. 407–436). New York, NY: Springer.

Weiss, A. J., & Wilson, B. J. (1998). Children’s cognitive and emotional responses to the portrayal of negative emotions in family-formatted situation comedies. Human Communication Research, 24, 584–609.

Whitbeck, L., Yoder, K. A., Hoyt, D. R., & Conger, R. D. (1999). Early adolescent sexual activity: A developmental study. Journal of Marriage and the Family, 61, 934–946.

Wiggers, M., & van Lieshout, C. F. (1985). Development of recognition of emotions: Children’s reliance on situational and facial expressive cues. Developmental Psychology, 21(2), 338–349.

Wilkinson, R. B. (2004). The role of parental and peer attachment in the psychological health and self-esteem of adolescents. Journal of Youth and Adolescence, 33(6), 479–493.

Wilson, B. J. (1991). Children’s reactions to dreams conveyed in mass media programming. Communication Research, 18, 283–305.

Wilson, B. J., & Drogos, K. L. (2009). Children and adolescents: Distinctive audiences of media content. In M. B. Oliver & R. L. Nabi (Eds.), The SAGE handbook of media processes and effects (pp. 469– 485). Thousand Oaks, CA: Sage.

Wilson, B. J., & Smith, S. L. (1995, May). Children’s comprehension of and emotional reactions to TV news. Paper presented at the annual conference of the International Communication Association, Albuquerque, NM.

Wilson, B. J., & Smith, S. L. (1998). Children’s responses to emotional portrayals on television. In P. Anderson & L. Guerrero (Eds.), Handbook of communication and emotion: Research, theory, applications, and contexts (pp. 533–569). New York, NY: Academic Press.

Woolley, J. D., Boerger, E. A., & Markman, A. B. (2004). A visit from the Candy Witch: Factors influencing young children’s belief in a novel fantastical being. Developmental Science, 7(4), 456–468.

Wright, J. C., Huston, A. C., Reitz, A. L., & Piemyat, S. (1994). Young children’s perceptions of television reality: Determinants and developmental differences. Developmental Psychology, 30, 229–239.

Wright, J. C., Huston, A. C., Ross, R. P., Calvert, S. L., Rolandelli, D.,


Weeks, L. A., . . . Potts, R. (1984). Pace and continuity of television programs: Effects on children’s attention and comprehension. Developmental Psychology, 20, 653–666.

Zuckerman, M. (1994). Behavioral expressions and biosocial bases of sensation seeking. New York, NY: Cambridge University Press.




Children’s social worlds are increasingly constructed around consuming, as brands and products have come to determine who is “in” or “out,” who is hot or not, who deserves to have friends or social status.

—Juliet B. Schor Born to Buy: The Commercialized Child and the

New Commercial Culture (2004, p. 11)

Keeping brands young is critical for the long-term health of the brands. Businesses need to plan ahead and nurture the brands and customers of the future.

—Anne Autherland and Beth Thompson Kidfluence: The Marketer’s Guide to Understanding and

Reaching Generation Y—Kids, Tweens, and Teens (2003, p. 149)

Children are seen by some as commodities—as products to be sold to advertisers.

—Michael J. Copps, Federal Communications Commissioner Children Now’s conference on “The Future of

Children’s Media: Advertising” (2006, p. 5)

Marketing to children is by no means new, but children now play an increasingly important role, both as consumers in their own right and as influences on parents. They are exposed to a growing number and range of commercial messages, which extend far beyond traditional media advertising.

—David Buckingham The Material Child: Growing Up in Consumer Culture (2011, p. 5)


E ight-year-old Grace came home from 3rd grade one day and announced to her mother, “I need a Monster High doll, Mom. The one I like is named Draculaura.” Her mother was a bit surprised, given that, to her knowledge, Grace had not expressed any interest in such a doll before and none of her friends had one.

“What’s a Monster High doll?” her mother asked.

“They’re cool, Mom. They all have monster names like Frankie Stein and Clawdeen Wolf. But I like Draculaura. She has long black hair and pink boots and a pet bat. I love her outfits,” replied Grace.

“How do you know about these dolls?” her mother continued.

“Maddi told me about them. We watched some of their videos on YouTube at Maddi’s house and we even played a computer game. Mom, Draculaura has her own website!”

“What do the dolls do in these videos?” probed her mother.

“They put on makeup and write in their diaries. They all go to Monster High together,” Grace replied.

On the next trip to Target, Grace spotted a display of Monster High dolls in one of the aisles and shrieked, “Mom, can I have one, pleeeeeease?”

Grace’s mom checked the price, weighed this struggle against all the others she might encounter that day, and reluctantly put one of the $21.99 dolls into the shopping cart. Along with millions of other parents, she caved in to what has been called the “nag factor” in the world of advertising. As it turns out, Grace’s mom got away pretty cheaply that day. Anyone searching can find 517 different toy products and apparel items associated with Monster High dolls. Children and their parents can purchase, for example, sundry dolls and accessories, a Monster High roadster and scooter for the dolls, a high school doll playhouse, wide-ruled notebooks, pencil sets, nail polish, hairclips, and even a digital video recorder (see Figure 2.1). And all of this is marketed without the typical TV cartoon series! Instead, Mattel has created a financially successful brand that is now sold in 35 countries—all based on a website, a few TV specials on Nickelodeon, a set of videos on YouTube, and a chapter book series. A full-length movie titled Monster High: Ghouls Rule was released on DVD in late 2012, coinciding with Halloween.

It is estimated that more than $17 billion a year is now spent on


advertising and marketing to children (Lagorio, 2009), representing almost three times the amount spent just 20 years ago (McNeal, 1999). Marketers are paying more attention to young consumers these days for at least three reasons. First, American children today have a great deal of their own money to spend. Consumers younger than age 12 spent $2.2 billion in 1968; roughly 35 years later, this amount had risen dramatically to $42 billion (McNeal, 2007). As seen in Figure 2.2, children’s spending power has steadily risen over the years. Much of this increase comes from children earning more money for household chores and receiving more money from relatives on holidays (McNeal, 1998). As might be expected, teens spend even more than children—teens spent roughly $200 billion in the year 2011 alone (Business Wire, 2011). In fact, the average American teenager spends nearly $100 a week on such products as clothes, candy, soft drinks, and music (Teenage Research Unlimited, 2004).

Figure 2.1 Monster High merchandise.

Second, in addition to spending their own money, young people influence their parents’ consumer behaviors. At an early age, children give direction to daily household purchases such as snacks, cereals, toothpaste, and even shampoos. As they get older, teens often voice opinions about what type of car to buy, what new media equipment is needed, and even where to go on vacation. And this influence has grown over the years. In the 1960s, children influenced about $5 billion of their parents’ purchases. By 1984, that figure had increased to $50 billion, and by 2005, it had leaped to $700 billion (McNeal, 2007). Relaxed parenting styles, increased family incomes, higher divorce rates, and more parents working outside the home are some of the historical changes that may account for children’s increased economic influence in the family (see Valkenburg & Cantor, 2001).



Third, marketers recognize that the children of today represent adult consumers of tomorrow. Children develop loyalties to particular brands of products at an early age, and these preferences often persist into adulthood (Moschis & Moore, 1982). Many companies today, such as McDonald’s and Coca-Cola, engage in what is called “cradle-to-grave” marketing in an effort to cultivate consumer allegiance at a very early age (McNeal, 1998).

Figure 2.2 Annual spending power of U.S. children younger than 12 years of age.

SOURCE: Adapted from McNeal (1998, 2007).

Figure 2.3



SOURCE: © Tribune Media Services, Inc. All rights reserved. Reprinted with permission.

Marketers have developed sophisticated strategies for targeting young consumers. Magazines such as Teen Vogue and Sports Illustrated Kids contain glossy full-page ads promoting clothes, shoes, and beauty products. Websites targeted to children feature all types of advertising, and even schools are marketing products to children. By far, the easiest way to reach young people is through television. Recent estimates suggest that the average American child sees more than 25,000 television ads per year (Gantz, Schwartz, Angelini, & Rideout, 2007), although the amount varies depending on the age of the viewer (see Figure 2.3). But marketers are exploring new ways to reach young consumers through online sources and through personal, handheld technologies such as iPods and cell phones.

In this chapter, we will explore advertising messages targeted to children and teens. First, we will examine how marketing to children has changed over the years, focusing primarily on television advertising. Then we will look at the amount and nature of television advertising targeted to youth. Next we will give an overview of how children cognitively process and make sense of advertising. Then we will examine the persuasive impact of advertising on youth. The chapter will then turn to more recent marketing efforts targeted to children, including viral marketing, marketing in schools, product placement, and online advertising. We will close with an overview



of efforts to teach advertising literacy. Regulation of advertising is covered in Chapter 13 on children’s media policy. It should be noted that two other chapters in this book deal with advertising as it relates to specific health hazards. Chapter 6 examines the advertising of cigarettes and alcohol, and Chapter 7 looks at the impact of food advertising on nutrition. The focus here is primarily on the advertising of toys, clothes, and other consumer goods, although food products will be referenced occasionally as well.

Historical Changes in Advertising to Children Efforts to advertise products to children date back to the 1930s, the early days of radio. Companies such as General Mills, Kellogg’s, and Ovaltine routinely pitched food products during child-oriented radio shows such as Little Orphan Annie and Story Time (Pecora, 1998). Household products such as toothpaste and aspirin were also marketed during children’s programming. In these earliest endeavors, children were considered important primarily because they were capable of influencing their parents’ consumer behavior.

In the 1950s, children gradually became recognized as consumers in their own right (Pecora, 1998). The sheer number of children increased so dramatically during this decade that it is now referred to as the baby boomer period. In addition, parents who had lived through the Depression and World War II experienced a new level of economic prosperity that they wanted to share with their offspring (Alexander, Benjamin, Hoerrner, & Roe, 1998). As noted by Kline (1993), “the 1950s’ family became preoccupied with possession and consumption and the satisfaction that goods can bring” (p. 67). And of course, the advent of television offered new ways to demonstrate products to captive audiences of parents and children (Pecora, 1998).

The earliest television advertising looked very different than it does today. At first, programmers were more interested in getting people to buy television sets than in attracting advertisers (Adler, 1980). Some programs were offered by the broadcast networks themselves with no commercial sponsorship at all. Other programs had a single sponsor that would underwrite the entire cost of the 30-minute or 60-minute time slot. Consequently, there were fewer interruptions, and the sponsors sometimes pitched the company rather than any specific product. As more and more American homes purchased sets, the focus shifted toward attracting this



large potential audience to one program or network over others. Programs also became more expensive to produce, thereby increasing the cost of advertising time so that more sponsors were necessary to share the burden.

In one of the only systematic studies of early TV advertising, Alexander and colleagues (1998) assessed 75 commercials that aired during children’s shows in the 1950s. The researchers found that the average length of a commercial was 60 seconds, considerably longer than the 15- and 30- second ads of today. In addition, less overall time was devoted to advertising—only 5 minutes per hour in the 1950s compared with roughly 11 minutes per hour today (Gantz et al., 2007). Reflecting the fact that ads were directed more at families than specifically at children, household products such as appliances, dog food, and even staples such as peanut butter were commonly pitched. Nearly all ads were live action rather than animated. And the practice of host selling—using a character from the interrupted program to endorse a product in the commercial segment—was quite common. In fact, 62% of the ads featured some form of host selling, which has since been banned.

In his book Out of the Garden: Toys, TV, and Children’s Culture in the Age of Marketing, Kline (1993) argued that 1955 was a turning point in television advertising to children. That year marked the debut of the highly successful TV show The Mickey Mouse Club. In great numbers, children rushed out to buy Mickey Mouse ears, guitars, and other paraphernalia, demonstrating their own purchasing power. Shortly thereafter, the toy industry moved aggressively into television.

In the 1960s, the broadcast networks also recognized the revenue potential of targeting children. However, adults continued to be the most profitable consumers to reach. Children’s programs still airing in the valuable prime-time period were therefore shifted to Saturday morning, when large numbers of children could be reached efficiently and cost- effectively with cartoons. Throughout the 1970s, the networks increased the number of Saturday morning hours they devoted to children’s programming in response to marketers’ increasing interest in young consumers.

The 1980s saw the birth of toy-based programs (Pecora, 1998). Creating spin-off toys based on popular children’s shows is a practice that dates back to the early days of radio. Toy-based programs are slightly different, however, because they are conceived for the sole purpose of promoting new toys. Hence, critics have charged that the shows themselves are actually half-hour commercials. In an unusual twist, toy manufacturers and producers



come together at the earliest stage of program development. Shows are created with the consultation and often the financial backing of a toy company. In her book The Business of Children’s Entertainment, Pecora (1998) argued that, in the 1980s,

the line between sponsorship and program became blurred as producers, looking to spread the risk of program production costs, turned to toy manufacturers, and toy manufacturers, wanting to stabilize a market subject to children’s whim and fancy, turned to the media. (p. 34)

The first example of such a partnership occurred in 1983, when Mattel joined together with the Filmation production house to create He-Man and the Masters of the Universe. In the deregulated era of the 1980s, these mutually beneficial arrangements proliferated. In 1980, there were no toy- based programs; by 1984, there were 40 of them on the air (Wilke, Therrien, Dunkin, & Vamos, 1985). According to Pecora (1998), the success of toy- based shows such as The Smurfs meant that “neither toy nor story is now considered without thought of its market potential” (p. 61). She went on to argue that by the 1990s, programming was evolving “not from the rituals of storytelling but rather the imperative of the marketplace” (p. 59).

Today, the proliferation of cable and independent networks has opened up new avenues for reaching children. Disney has its own television network, and others such as Nickelodeon and Cartoon Network have been tremendously successful in targeting the child audience. Recognizing the economic benefits, marketers are now segmenting the child audience into different age groups. Teenage consumers are widely recognized for their spending power, as evidenced by the creation of MTV, Black Entertainment Television (BET), ABC Family, TeenNick, the CW Network (a merger of the WB and UPN networks), and other specialized channels devoted to attracting adolescents and young adults. And advertisers are responsible for coining the term tweens to refer to 8- to 12-year-olds who are on the cusp of adolescence, are deeply interested in brand names and fashion, and spend a lot of time at shopping malls (Wells, 2011). Even the youngest age groups are being targeted. In 2006, a 24-hour cable channel called BabyFirstTV was launched to provide television programming for babies and toddlers. The network airs no commercials, but there is a link on its website that allows parents to buy BabyFirst DVDs, plush toys, and home decor. Infant videos and DVDs accrue more than $100 million in sales a year (Shin, 2007).

Thus, the current market is far different from the market of the 1950s,



when the broadcast networks dominated television and there were only a few other media options. Today, licensed characters such as Dora the Explorer and SpongeBob SquarePants routinely cross over from television to other media such as books, DVDs, film, electronic games, and computer software. And numerous media outlets actually specialize in child- and teen-oriented content in an effort to attract affluent young consumers.

Content Analyses of Television Advertising What do ads that are targeted to children look like? Most of the research has focused on television advertising, in part because children continue to spend so much time with this medium. In one early content analysis, Barcus (1980) looked at advertising during children’s shows in 1971 and in later samples of programming from 1975 and 1978. In 1971, roughly 12 minutes of each broadcast hour were devoted to commercials, a marked jump from the 5 minutes documented in the 1950s (Alexander et al., 1998). Given that the typical ad had shrunk to 30 seconds, children on average were exposed to 26 different commercials each hour. The time devoted to advertising dropped in 1975 to roughly nine minutes per hour (Barcus, 1980). This shift reflects pressure on the industry in the mid-1970s from child advocacy groups and the federal government to reduce advertising to children (see Chapter 13).

What products were being pitched? In the 1978 sample, Barcus (1980) found that most advertisements were for cereal, candy, toys, and fast food restaurants. In fact, food ads generally accounted for nearly 60% of all commercials targeted to children (cereal, 24%; candy, 21%; fast foods, 12%). Barcus also found that the appeals used in children’s ads were mostly psychological rather than rational. Instead of giving price, ingredient, or quality information, ads typically focused on how fun the product was or how good it tasted.

By the 1980s, commercials had been shortened even more so that many lasted only 15 seconds (Condry, Bence, & Scheibe, 1988). Although the total time devoted to ads remained somewhat constant, the briefer messages meant that children were exposed to a greater number of ads during any given hour of broadcast television.

Using a more comprehensive sample than in earlier research, Kunkel and Gantz (1992) examined a composite week of child-oriented programming



during February and March 1990. Programming was sampled from seven different channels: the three major broadcast networks, two independent stations, and two cable channels (Nickelodeon and USA). The researchers found more advertising on the networks (10 minutes/hour) than on the independents (9 minutes/hour) or cable (6 minutes/hour). Consistent with earlier research, the same types of products dominated commercials during children’s programming. Roughly 80% of all ads were for toys, cereals, snacks, and fast food restaurants (see Figure 2.4). Interestingly, only 3% of all ads were for healthy foods. When the researchers compared channel types, they found that toy ads were most prevalent on independent channels, whereas ads for cereals and snacks were most common on the broadcast networks. Cable channels offered the most diverse range of products, with 35% of the ads falling into the “other” category. Kunkel and Gantz (1992) reasoned that toy ads, which have been consistently criticized for deceptive practices, may show up less often on the broadcast networks because of their more rigorous self-regulatory standards.

Figure 2.4 Types of products advertised during children’s TV programming.

SOURCE: Adapted from Kunkel and Gantz (1992).

The researchers also coded the primary persuasive appeal used in each ad. The most prevalent theme was fun/happiness, which accounted for 27% of all ads. Two other common appeals were taste/flavor (19%) and product performance (18%). In contrast, appeals based on price, quality of



materials, nutrition, and safety each accounted for less than 1% of the ads.

Rather than focusing just on programs targeted to children, the Kaiser Family Foundation sponsored a comprehensive study of all advertising content on the channels that children watched most (Gantz et al., 2007). The study looked at a composite week of programming airing in 2005 across 13 networks channels, including Nickelodeon, Disney, Cartoon Network, the four major broadcast networks (ABC, NBC, CBS, and FOX), PBS, BET, and MTV. There was considerable variation in the amount of advertising and promotional messages across the channels; PBS (1 minute/hour) and Disney (20 seconds/hour) had the least amount of such content, whereas ABC, CBS, and FOX had the most (roughly 14 minutes/hour). On average, the broadcast networks devoted more time to advertising than did the cable networks, a finding consistent with the earlier Kunkel and Gantz (1992) study.

The study looked closely at food advertising in particular. Although food commercials are common on television, food is marketed even more to children than to adults. Food ads constituted 13% of the ads on the four major broadcast networks, but they constituted 32% of the ads on three of the top children’s networks (ABC Family, Nickelodeon, and Cartoon Network). In fact, half of all advertising time during children’s shows was devoted to food commercials. And most of these food ads were for cereal (31%), candy and snacks (30%), and fast food (11%). Commercials for healthy foods were very rare in the 2005 sample. Of the 8,854 food commercials analyzed in the Kaiser Family Foundation study, there were no ads for fruits or vegetables targeted at children or teens. Consistent with the low nutritional value of the products, most food ads emphasized taste and fun as the main persuasive appeals (see Figure 2.5). All of these patterns are comparable to what Kunkel and Gantz (1992) had found 15 years previously. Similar findings have been documented by other researchers as well (Warren, Wicks, Wicks, Fosu, & Chung, 2008).

Therefore, despite the proliferation of channels on television, it seems that advertising to children has not changed much over the years. The same products dominate commercials, and the selling appeals continue to focus more on fun, happiness, and taste than on actual information about the product.

Content analyses have also looked at other qualities inherent in children’s advertising, such as how gender is portrayed. In a study of nearly 600 commercials targeted to children, Larson (2001) compared ads featuring



only girls or only boys with those featuring both girls and boys. She found that girls-only ads were far more likely to feature a domestic setting such as a bedroom or a backyard than were boys-only or mixed-gender ads. Boys- only ads seldom occurred around the house and instead featured settings such as restaurants, video arcades, and baseball fields. The types of interactions that occurred also differed across ads. More than 80% of the girls-only ads portrayed cooperation, whereas less than 30% of the boys- only ads did. Consistent with gender stereotypes, nearly 30% of the boys- only ads featured competitive interactions, but none of the girls-only ads did. Finally, there were gender differences across the types of products being pitched. Food commercials were most likely to feature girls and boys together, whereas toy ads typically were single gender in nature. Commercials targeted to boys were frequently for video games or action figures, and those targeted to girls were often for Barbie dolls. A more recent study looking just at toy ads on Nickelodeon confirmed these patterns (Kahlenberg & Hein, 2010).

Figure 2.5 Examples of food ads emphasizing taste and fun.

Gender stereotypes exist in commercials targeted toward teens, too. In one study, ads aimed at male teens emphasized competition, having the best, and achievement in their persuasive appeals, whereas ads targeted to female teens emphasized romance, sexuality, and belonging to a group (Buijzen & Valkenburg, 2002).

Commercials can convey stereotypes in more subtle ways as well. One study examined the production techniques used in toy ads directed to boys versus girls (Welch, Huston-Stein, Wright, & Plehal, 1979). Toy ads for


boys were faster in pace, used more abrupt transitions such as cuts, and had more sound effects and other types of noise. In contrast, toy ads directed at girls used smoother transitions, such as fades and dissolves between scenes, and had more background music. Such gender stereotypes in production techniques have been found in children’s ads in the UK too (Lewin-Jones, & Mitra, 2009). Interestingly, elementary schoolers readily identify these different production techniques as being associated with a “boy’s toy” or a “girl’s toy” (Lewin-Jones & Mitra, 2009), even when the toy itself is gender neutral (e.g., a mobile) (see Huston, Greer, Wright, Welch, & Ross, 1984). There are also stereotypes about race and ethnicity in commercial messages targeted to children. Advertisements featuring White children are far more common than ads featuring children of color are (Bramlett-Solomon & Roeder, 2008; Larson, 2001). Furthermore, ads featuring Black children are more likely to sell convenience foods, especially fast foods, than are ads featuring no Black children (Harrison, 2006). Indeed, marketers target African American consumers with ads for high-calorie and low-nutrient foods and beverages (Institute of Medicine, 2006). Asians are also stereotyped in children’s ads, and are commonly shown using computers and other technologies, for example (Bramlett-Solomon & Roeder, 2008).

Commercials for children have also been analyzed for violence. Palmerton and Judas (1994) looked at ads featured during the 21 top-rated children’s cartoons in 1993. One-third of the ads contained overt displays of physical aggression, most commonly found in toy commercials. Furthermore, ads that were clearly targeted to boys were far more likely to feature violence than were ads targeted to girls. Literally every commercial for action figures in the sample contained violence. This link between violence and ads directed at boys has been documented in more recent research (Larson, 2001).

In summary, the typical hour of television features anywhere from 10 to 14 minutes of advertising on the channels that youth watch most (Gantz et al., 2007). A majority of the commercial messages targeted to children market toys or food products that are not particularly healthy. In fact, the average tween (8–12 years of age) in this country sees 21 food ads a day on TV (Gantz et al., 2007), most of which feature candy, snacks, and fast foods. The commercials designed for youth do not offer much in the way of “hard” information about products, such as what they are made of or how much they cost. Instead, the appeals are largely emotional ones based on fun or good taste. Toy ads in particular are fairly stereotyped in terms of gender. Ads targeted to boys typically sell violent toys that are demonstrated through


action, force, and noise. Ads for girls, in contrast, sell dolls, which are featured in a quieter, slower, and more domestic environment. Commercials targeted to teens show similar gender stereotypes; ads for males tend to focus on competition, whereas ads for females focus more on relationships. The next section addresses how young people respond cognitively to these messages.

Cognitive Processing of Advertising In the United States, policies dating back to the Communications Act of 1934 stipulate that advertising must be clearly identifiable to its intended audience (Wilcox & Kunkel, 1996). In other words, commercials should be recognized by the target audience as obvious attempts to persuade. If a viewer is unaware of or incapable of recognizing an ad, then she or he is presumably more vulnerable to its persuasive appeals. Under such circumstances, commercial messages are thought to be inherently unfair and even deceptive. Because of the potential for unfairness, researchers as well as policymakers have focused on how children of different ages make sense of advertising.

Attention to Advertising One of the first questions to ask is whether children pay any attention to

advertising. Marketers use sound effects, bright colors, jingles, animated characters, and a variety of other production techniques to attract consumers. In fact, ads are typically louder in volume than accompanying programs. All of these techniques are perceptually salient and, as we learned in Chapter 1, likely to capture the attention of younger children in particular.

Certainly many adults use commercial time to leave the room, engage in other activities, or even to change the channel. With digital video recording devices, consumers can record their favorite programs and skip over the advertising. Based on in-home observation, one study found that adults pay visual attention to programming 62% of the time and to ads only 33% of the time (Krugman, Cameron, & White, 1995). As it turns out, children’s attention depends on the age of the viewer. In one early study, mothers of 5- to 12-year-olds were trained to observe their children’s attention to commercials aired during different types of TV programming (Ward,



Levinson, & Wackman, 1972). All children exhibited a drop in attention when a commercial was shown, and attention also decreased over the course of several ads shown in a series. However, the youngest children (5– 7 years) generally displayed higher levels of attention to both commercials and programs, whereas the 11- and 12-year-olds were most likely to stop looking when an ad came on. A more recent study that videotaped families while they watched television found that 2-year-olds paid just as much attention to ads as to programs (Schmitt, Woolf, & Anderson, 2003). In contrast, 5-, 8-, and 12-year-olds looked more at programs than ads, with the difference increasing by age (see Figure 2.6). These findings suggest that older children, like adults, screen out advertisements. The data also suggest that very young children may not make clear distinctions between program and nonprogram content, an issue we will turn to in the next section.

Similar age differences have been found in laboratory research. Zuckerman, Ziegler, and Stevenson (1978) videotaped 2nd through 4th graders while they watched a brief program with eight cereal commercials embedded in it. Overall, children paid less attention to the ads than to the program, but once again, attention to the commercials decreased with age.

Younger children’s heightened attention to ads may be due in part to attention-getting techniques such as jingles, animation, and slogans used to pull in the audience. Greer, Potts, Wright, and Huston (1982) found, for example, that preschoolers paid more attention to advertisements that contained high action, frequent scene changes, and numerous cuts than to ads without these production features. Likewise, Wartella and Ettema (1974) found that compared with kindergarten and 2nd-grade children, preschoolers’ level of attention to ads varied more as a function of visual and auditory attributes of the message. Such patterns are consistent with younger children’s tendency to focus on and be swayed by perceptually salient cues in the media, as discussed in Chapter 1.

Figure 2.6 Percentage of time looking at TV screen during commercials and programs as a function of age of child.


SOURCE: Adapted from Schmitt, Woolf, and Anderson (2003).

Overall, then, preschoolers and early elementary schoolers pay more attention to television advertising than older children do. In part, this may be due to the strong perceptual attributes commonly found in commercials. However, the relatively steady attention patterns during transitions from programming to advertising also suggest that younger children may not distinguish these two types of messages very clearly.

Discrimination Between Ads and Programming Discrimination can be tested by showing different types of television

content and asking children to identify what they are watching. For example, Palmer and McDowell (1979) stopped a videotape of Saturday morning content at preselected points and asked kindergartners and 1st graders whether they had just seen “part of the show” or a “commercial.” The young elementary schoolers were able to accurately identify commercials only 53% of the time, which is roughly equivalent to chance guessing.

In other studies employing similar techniques, young children’s discrimination skills have sometimes been better and are often above chance levels (Butter, Popovich, Stackhouse, & Garner, 1981; Levin, Petros, & Petrella, 1982). Nevertheless, age differences are consistently found through the preschool years; 3- and 4-year-olds are less able to make these distinctions than are 5-year-olds (Butter et al., 1981; Levin et al., 1982).



Once children learn to differentiate a TV ad from a program, they often do so on the basis of perceptual features rather than more conceptual properties of the two messages. For instance, when Palmer and McDowell (1979) asked kindergartners and 1st graders how they knew a particular segment was a commercial, the predominant reason cited was the length of the message (“because commercials are short”). Other studies that have interviewed children about ads versus programs without showing television content support this finding (Blatt, Spencer, & Ward, 1972; Ward, Wackman, & Wartella, 1977).

We should point out that the television industry employs separation devices to help signal to child viewers that a commercial break is occurring. These devices vary considerably in degree, from the simple insertion of several seconds of blank screen between a program and an ad to a more complex audiovisual message indicating that a program “will be right back after these messages.” As it turns out, these types of separators do not help young children much. Studies comparing blank screens, audio-only messages, visual-only messages, and audiovisual separators have found little improvement in young children’s discrimination abilities with any of these devices (Butter et al., 1981; Palmer & McDowell, 1979; Stutts, Vance, & Hudleson, 1981). One possible reason for the ineffectiveness of such separators is that they may be too brief to be noticed. Another possibility is that they look too much like adjacent programming. In many cases, visuals of the characters or part of the soundtrack from the show are actually featured in the separators. A more effective device may be one that is far more obvious. For example, a child or adult spokesperson who has no affiliation with the programming could state, “We are taking a break from the program now in order to show you a commercial.”

To summarize, the research shows that a substantial number of preschoolers do not recognize a commercial message on TV as distinctly different from programming. By age 5, most children are capable of making this distinction, although it is typically based on somewhat superficial qualities of the messages, such as how long they are. Still, being able to identify and accurately label a commercial does not necessarily mean that a child fully comprehends the nature of advertising, a topic we turn to next.

Comprehension of Advertising Adult consumers realize that advertisements exist to sell product and

services. This realization helps a person to interpret a commercial as a



persuasive form of communication. According to Roberts (1982), an “adult” understanding of advertising entails four ideas or realizations: (a) the source has a different perspective (and thus other interests) than that of the receiver, (b) the source intends to persuade, (c) persuasive messages are biased, and (d) biased messages demand different interpretive strategies than informational messages do. Most research dealing with children has focused on the first two ideas, encompassed in studies of how and when young viewers understand the selling intent of ads. Less attention has been given to children’s recognition of bias in advertising, relating to the last two ideas. Not reflected in Roberts’s list is the notion that other facets of advertising require understanding too, such as disclaimers. This section will consider all three topics: children’s comprehension of selling intent, of advertiser bias, and of disclaimers such as “parts sold separately.”

Understanding Selling Intent. Recognizing the selling motive that underlies advertising is not a simple task. For one thing, the actual source of a commercial is rarely identified explicitly. A television commercial, for example, might show children playing with a toy or eating a type of cereal, and yet the company that manufacturers these products is invisible. It is easy to assume that the “source” of the message is the child, the celebrity, or the animated character, who in fact is merely demonstrating a new product that is available.

Research suggests that younger children’s views are just this naive. In one early study, Robertson and Rossiter (1974) asked 1st-, 3rd-, and 5th-grade boys a series of open-ended questions, such as, “What is a commercial?” and “What do commercials try to get you to do?” First graders often described commercials as informational messages that “tell you about things.” Although older children did this too, they were far more likely to describe advertising as persuasive in nature (i.e., “Commercials try to make you buy something”). In fact, the attribution of selling intent increased dramatically with age: Only 53% of the 1st graders mentioned selling intent, whereas 87% of 3rd graders and 99% of 5th graders did so.

Almost 20 years later, a similar study found the same pattern (Wilson & Weiss, 1992). When asked what commercials “want you to do,” only 32% of 4- to 6-year-olds mentioned the selling intent of ads. Instead, this youngest age group was far more likely to cite an entertainment (e.g., “they want you to watch them,” “make you laugh”) or informational (“show you stuff”) function for commercials. In contrast, 73% of 7- to 8-year-olds and a full 94% of 9- to 11-year-olds spontaneously mentioned the selling intent of



commercials. A host of other studies using similar interviewing techniques support these age trends (Batada & Borzekowski, 2008; Blatt et al., 1972; Ward et al., 1977).

Given variations in development, it is difficult to pinpoint the specific age at which the idea of selling intent is mastered. Nevertheless, most studies suggest that children begin to develop an understanding of the persuasive purpose of advertising around the age of 8 (for reviews, see Kunkel et al., 2004; Smith & Atkin, 2003).

Some scholars have argued that the reliance on verbal measures can mask younger children’s true abilities, which may be hampered by language difficulties (Macklin, 1987; Martin, 1997). To test this notion, Donohue, Henke, and Donohue (1980) devised a nonverbal measure to assess 2- to 6- year-olds’ understanding of selling intent. After watching a Froot Loops commercial, children were asked to choose which of two pictures—one of a mother and child picking out a box of cereal at a supermarket and the other of a child watching television—illustrated what the commercial wanted them to do. A full 80% of the young children selected the correct picture, well above chance level with two options. However, as seen in Table 2.1, several efforts to replicate this finding with younger children have been unsuccessful (Macklin, 1985, 1987). For example, Macklin (1985) used a set of four pictures, reasoning that the two used by Donohue and his colleagues were too easy (i.e., only one of the pictures featured cereal, which made it obviously more relevant). When four pictures were shown, 80% of 3- to 5-year-olds could not select the correct one.

Theoretically, it makes sense that comprehension of selling intent might be difficult for younger children. Certain cognitive skills seem to be required first, such as the ability to recognize the differing perspectives of the seller and receiver. In support of this idea, one study found that the ability to role-take was a strong and significant predictor of elementary schoolers’ understanding of the purpose of advertising (Faber, Perloff, & Hawkins, 1982). Interestingly, exposure to television did not correlate with comprehension of selling intent, suggesting that viewing numerous television ads is not enough to help a child recognize the purpose of commercials.

Table 2.1 Comparison of Preschoolers’ Correct Responses Across Studies Using Different Nonverbal Measures of Comprehension of Selling Intent


SOURCE: Adapted from Macklin (1985, 1987).

In addition to role taking ability, comprehension of selling intent seems to depend on the ability to think abstractly about what persuasion is and who the true source of the message is. Consistent with this idea, one study found that the ability to identify the source of advertising and the awareness of the symbolic nature of commercials were two skills that helped differentiate children who understood the purpose of ads from those who did not (Robertson & Rossiter, 1974).

To summarize, a large body of research suggests that very young children do not comprehend the purpose of advertising and often view it as informational in nature. The ability to role-take and the ability to think conceptually have been identified as important precursors to being able to appreciate advertising as a form of persuasion. Given that such skills do not emerge until the later elementary school years (see Chapter 1), it stands to reason that understanding the selling intent of commercials does not occur much before the age of 8.

As a final issue, we might ask why comprehending the purpose of advertising is so important. Perhaps the naive view of a young child is just that—a naive view, with little or no consequence. Several studies suggest otherwise. Comprehension of selling intent seems to alter a child’s reactions to advertising (Robertson & Rossiter, 1974; Ward & Wackman, 1973). For example, Robertson and Rossiter (1974) found that elementary schoolers who understood the persuasive intent of commercials were less likely to trust ads, more likely to dislike them, and less likely to want advertised



products. In other words, recognizing the motives behind commercials may help trigger a cognitive defense or shield against such messages. Interestingly, the opposite pattern was found among children who viewed ads as informational—they expressed higher trust and more liking of such messages.

However, some have maintained that comprehension of selling intent may not be enough to safeguard children from ads (Rozendaal, Buijzen, & Valkenburg, 2009). After all, even adults who presumably appreciate the intent of commercials are influenced routinely by persuasive tactics. In a survey of nearly 300 8- to 12-year-olds, Rozendaal and her colleagues (2009) found that understanding the persuasive intent of advertising was effective in reducing the impact of ads on children’s desire for products, but only among 10- to 12-year-olds. The opposite effect occurred for children under 10—understanding intent actually increased product desire, although comprehension was lower overall. The researchers argued that in order to defend themselves against ads, children may need even more sophisticated cognitive strategies, such as understanding particular persuasive tactics and recognizing bias in messages. The next section will explore these more advanced skills.

Recognition of Bias. Appreciating that advertising is inherently one sided and therefore biased is another facet of sophisticated consumerism (Roberts, 1982). In fact, Kunkel (2010) has argued that understanding selling intent (i.e., that an ad is trying to sell a product) is conceptually distinct from the more sophisticated understanding of persuasive intent, which entails a recognition that sales messages are slanted and require skeptical evaluation. As it turns out, this more advanced realization is also age related in its development. In a large-scale study, Carter and his colleagues (2011) compared comprehension of selling intent versus persuasive intent among nearly 600 children (ages 4–12) after they watched a McDonald’s commercial. The researchers found that by age 8, a majority of children understood that the ad for a Happy Meal toy was trying to sell the product. However, the more sophisticated understanding of persuasive intent did not emerge until several years later, around age 11 or 12.

One challenge for children in recognizing bias is to overcome their tendency toward trusting messages. In interview situations, younger children are more likely to report that they believe what commercials say than older children are (Bever, Smith, Bengen, & Johnson, 1975; Robertson & Rossiter, 1974). For instance, Ward and his colleagues (1977) found that



50% of kindergartners said yes when asked, “Do commercials always tell the truth?” Only 12% of 3rd graders and 3% of 6th graders responded affirmatively to this question.

Similarly, Wilson and Weiss (1995) asked 4- to 11-year-olds a series of questions about advertising, including how much commercials tell you about a toy and how often commercials tell the truth. As seen in Figure 2.7, strong age trends were found on three different measures, all indicating growing skepticism of advertising across the childhood years. Even while watching television, older children spontaneously express more negative comments and criticisms of ads than younger children do (Ward, Levinson, et al., 1972).

Several factors contribute to younger children’s trust in advertising. First, younger children have more difficulty differentiating appearance from reality, as discussed in Chapter 1 (see Figure 2.8). They rely heavily on perceptual cues in judging an ad (Ward & Wackman, 1973) and thus are likely to believe that products look and perform the way they are depicted in commercials. Second, younger children have less experience as consumers. One way to learn expeditiously that ads can be deceptive is to experience disappointment over a purchase. By 6th grade, the vast majority of children can describe a product they bought that turned out to be worse than what was depicted in an ad (Ward et al., 1977). As children grow older, they are more likely to cite their own consumer experiences as reasons for not trusting ads (Ward & Wackman, 1973). Third, the failure to understand selling intent makes a young child more trusting. In one study, a full 100% of older, cognitively mature children referred to advertisers’ motives when asked to explain why commercials do not always tell the truth (Ward & Wackman, 1973). For example, older children based their assessments of bias on the fact that advertisers “want you to buy their product” and want you to think their product is good.”

Figure 2.7 Age differences in children’s trust in advertising.


SOURCE: Adapted from Wilson and Weiss (1995).


Figure 2.8

SOURCE: ©1995 Universal Press Syndicate.

It makes sense that skepticism would help children to be less gullible when they confront commercial messages. One study found that 8- to 12- year-olds who felt distrustful and negative toward advertising evaluated particular commercials less favorably than did those who were more trusting of advertising (Derbaix & Pecheux, 2003). Unfortunately, the study did not measure how much children wanted to buy the products in the commercials. Some scholars have speculated, though, that even the most savvy child consumer can be misled by powerful or seductive persuasive tactics (Derbaix & Pecheux, 2003). In support of this idea, children’s understanding of advertising tactics (e.g., humor, celebrity endorsement, premiums) increases steadily between the ages of 8 and 12 (Rozendaal, Buijzen, & Valkenburg, 2011). Yet even 12-year-olds do not match adultlike comprehension for every persuasive ploy.

Skepticism toward advertising continues to develop into early adolescence. One longitudinal study found relatively high levels of mistrust in commercial claims as well as advertiser motives in a large sample of middle schoolers (Boush, Friestad, & Rose, 1994). On a five-point scale, the students’ average ratings were all around four. (Zero indicated strong agreement with statements such as, “Advertisers care more about getting you to buy things than what is good for you” and “TV commercials tell only the good things about a product; they don’t tell you the bad things.”) Yet skepticism did not increase much within a single school year, nor were there any significant differences between 6th and 8th graders in these beliefs.

As a child reaches the teen years, then, factors other than cognitive development may be important in predicting who is most critical of advertising. One study found that skepticism toward advertising was higher


among teens who watched more television, who came from families that stressed independent thinking, and who relied on peers for information about products (Mangleburg & Bristol, 1999). In contrast, skepticism was lower among teens who reported trying to impress peers with product purchases. This research suggests that once a young person is cognitively capable of recognizing the motives and tactics of advertisers, socializing forces such as parents and peers may be needed to make such information salient on a regular basis.

Comprehension of Disclaimers. Disclaimers are warnings or disclosures about a product, intended to prevent possible deception caused by an ad. “Batteries not included,” “Parts sold separately,” and “Part of a balanced breakfast” are examples of disclaimers that are quite common in advertising to children. Kunkel and Gantz (1992) found that more than half of the commercials targeted to children contained at least one disclaimer, and 9% featured two or more.

Disclaimers are very common in commercials for food. In fact, about half of all food ads contain some type of disclaimer (Wicks, Warren, Fosu, & Wicks, 2009). Nearly three-fourths of all cereal ads feature such a message (Gantz et al., 2007)—typically, indicating that the advertised product is only “part of a nutritious/balanced breakfast.” Disclaimers are also frequently included in ads for pastries and bread (Gantz et al., 2007). Interestingly, food ads targeted to children and teens are more likely to contain disclaimers than are food ads targeted to adults (Gantz et al., 2007).

Typically, disclaimers are conveyed by an adult voiceover or by inserting the words in small print at the bottom of the screen (Muehling & Kolbe, 1999). It is rare for a disclaimer to be presented both auditorily and visually (Kunkel & Gantz, 1992; Wicks et al., 2009), even though the Federal Trade Commission recommends this practice to help children more easily detect such messages. Even young adults are better able to detect and remember disclaimers when they are presented in dual modalities (Morris, Mazis, & Brinberg, 1989).

Disclosures exist because of consumer pressure to ensure that advertisements give accurate information about products (Barcus, 1980). Yet disclaimers have been criticized as “jargon” because the wording is often fairly obscure (Atkin, 1980). In fact, research indicates that young children do not comprehend disclaimers very well. One study found that preschoolers exposed to a disclaimer in a toy ad were no better able to understand the workings of the toy than were those who saw the same ad



with no disclaimer (Stern & Resnik, 1978). Another study revealed that kindergarten and 1st-grade children had little understanding of what a “balanced breakfast” means and were far more likely to remember the Rice Krispies cereal in an ad than the milk, orange juice, or strawberries that accompanied it on the table (Palmer & McDowell, 1981). Cognitive as well as language development should help to make these disclaimers more accessible with age. One study found that 85% of 10-year-olds understood “Partial assembly required” in a toy ad, whereas only 40% of 5-year-olds did (Liebert, Sprafkin, Liebert, & Rubinstein, 1977).

Yet disclaimers could be designed in a more straightforward way even for younger children. In an innovative experiment, Liebert and colleagues (1977) exposed kindergartners and 2nd graders to a toy commercial under one of three conditions: no disclaimer at all, a standard disclaimer (“Partial assembly required”), or a modified disclaimer that contained simpler wording (“You have to put it together”). Regardless of age, children who heard the simplified disclaimer were significantly more likely to understand that the toy required assembly than were those who heard the standard disclaimer (see Figure 2.9). Interestingly, the standard wording was no more effective in helping children understand that the toy needed assembly than was having no disclaimer at all; less than 25% of children in either condition understood this idea. As a comparison, commercials targeting children in Turkey regularly feature child-friendly vocabulary rather than adult language in their disclaimers (Bakir, 2009).

To recap how children process advertising, most preschoolers have difficulty differentiating a television commercial from programming, and they do not comprehend the standard wording used in disclaimers in advertising. Thus, for this age group in particular, advertising may be unfair, given the legal principle that the audience must be capable of recognizing such content. By age 5 or 6, most children have mastered the distinction between a TV ad and a program, although it is based primarily on perceptual cues such as the length of the messages. As commercials get shorter and as they increasingly resemble adjacent programming, a kindergartner or 1st grader may have more difficulty making this distinction. Further complicating matters for younger children is the nature of advertising in newer media. Websites flash ads and banners, for example, that are mixed in seamlessly with content. In fact, some websites are entirely commercial in nature, as we will discuss below, although they may appear to be informational. The Internet requires even higher levels of cognitive sophistication to disentangle what is commercial from what is not.


Figure 2.9 Percentage of children who understood that toy required assembly as a function of type of disclaimer in ad.

SOURCE: Adapted from Liebert, Sprafkin, Liebert, and Rubinstein (1977).

Nevertheless, a young child’s ability to identify an ad still does not mean she or he comprehends its purpose. Initially, ads are viewed as informational or entertaining in nature, and young children express a high degree of trust in such messages. It is not until roughly 8 years of age that a child begins to understand the selling intent of such messages. This transition is facilitated by the development of role taking skills and conceptual thinking. By age 12 or so, most children are able to recognize the source of the message, the biased nature of commercials, and typical strategies that are used to persuade. This level of awareness, coupled with a rich base of consumer experience, means that by the teenage years, most youth are fairly critical and skeptical of advertising. The only caveat here is that all of this research has been done with television and not with newer media. Even so, children of all ages, like many adults, can still be persuaded by commercials, as we will discover next.

The Persuasive Impact of Advertising The most direct effect of an advertisement is to convince a consumer to



purchase a new product. Advertisers and companies alike believe in the power of advertising to do just that. There is no other way to explain the fact that companies paid $4 million for a 30-second commercial during the 2013 Super Bowl. But there are more subtle consequences of advertising too. For example, commercials can influence family interactions. Whenever a child tries to get a parent to buy something or a parent tries to resist that effort, conflict can occur. Researchers have looked at how often this occurs and with what consequences. In addition, extensive exposure to advertising may affect more general attitudes or values that youth hold regarding consumption, money, and even physical appearance. We discuss each of these potential influences in this section.

Brand Loyalty One of the goals of advertising is to create brand loyalty. Creating

branded characters that appeal to children is a crucial component of successful marketing (Institute of Medicine, 2006). Tony the Tiger was created in 1951 to promote Kellogg’s Frosted Flakes, and although he has become slimmer and more muscular, he is still used in advertising today. Ronald McDonald is recognized by nearly 96% of American children and is used to sell fast food internationally in more than 25 languages (Enrico, 1999). Through licensing agreements, popular television characters such as SpongeBob SquarePants are used to sell products as well.

It is not surprising that children are highly aware of brand names, jingles, and slogans associated with commercials and of the celebrities who endorse certain products (Burr & Burr, 1977; Fox, 1996). One study revealed that children between the ages of 8 and 12 could name five brands of beer but only four American presidents (Center for Science in the Public Interest, 1988). Another study found that teens remember brand names and recognize ad content better than adults do (Dubow, 1995).

Even preschoolers show awareness of brands and brand loyalty. One study asked 3- to 6-year-olds to match 22 brand logos to 12 different products pictured on a game board (Fischer, Schwartz, Richards, Goldstein, & Rojas, 1991). The children showed high rates of logo recognition (see Figure 2.10). More than 90% recognized the logo for the Disney Channel, but children even recognized logos for many adult products. More than 90% of the 6-year-olds in particular were able to match Old Joe (the cartoon character promoting Camel cigarettes) to a picture of a cigarette. Even when preschoolers cannot name a particular logo, they often recognize products



associated with the brand. For example, in one study very few preschoolers were able to identify the Home Depot logo, but many of them knew that you could buy tools, wood, and paint there (Kinsky & Bichard, 2011). Another study found that children as young as 2 years of age can recognize many brand logos for products (Valkenburg & Buijzen, 2005). In this same study, preschoolers who watched a great deal of television were more familiar with brand names than were preschoolers who watched little television.

Brand recognition seems to breed brand preference. One study had preschool children select which product they preferred from a series of eight choices involving a branded option and a carefully chosen nonbranded one (Pine & Nash, 2003). The nonbranded options were pretested to ensure that they matched the branded ones in size, color, and other perceptual qualities. Children chose the branded products 68% of the time. Preschool girls showed stronger brand loyalty than preschool boys did. Among the eight types of products presented (e.g., toy, cereal, chocolate bar, T-shirt), the only product that did not generate brand loyalty was training/running shoes. Using a slightly different approach, Robinson, Borzekowski, Matheson, and Kramer (2007) presented preschoolers with two samples each of five different fast food items (e.g., hamburger, French fries, milk). For each pair of items, one was packaged in McDonald’s wrapping and the other was packaged in plain paper. The foods or drinks inside the wrappings were identical, however. Children were asked to taste each sample and decide if the two were the same or if one tasted better. The preschoolers showed a strong preference for the foods and drinks they thought were from McDonald’s. In other words, the simple branding of the food items significantly influenced children’s taste perceptions.

Figure 2.10 Popular brand logos.


SOURCE: Tony the Tiger™, Frosted Flakes®, © 2008 Kellogg’s NA Co.; Joe Camel™, Camel Cigarettes®, © R. J. Reynolds Tobacco Company. All rights reserved.

Desire for Products Asking whether advertising creates a desire for products may seem like a

ridiculous question to some. American children wear T-shirts emblazoned with Pokémon characters, carry lunch boxes decorated with Disney images, wear designer jeans and Nike athletic shoes, and love anything with the word Abercrombie on it (see Figure 2.11). Adolescents seem even more conscious of brand names as well as the latest fads in clothing and technology. Where does all this consumer desire come from? When asked, most children report that they bought something because “you see it a lot” or “everybody has one” (Fox, 1996). As noted above, advertising often conveys the idea that a product will bring fun and happiness to a youngster’s life. Images of other children playing with a toy or eating at a fast food restaurant reinforce the notion that everyone else is doing it too.

But does exposure to advertising create desire? A number of surveys show that children who watch a lot of television want more advertised toys and actually consume more advertised foods than children with lighter TV



habits do (Atkin, 1982; Goldberg, 1990; Robertson & Rossiter, 1977; Robertson, Ward, Gatignon, & Klees, 1989). As an example, one study asked 250 children in the Netherlands to list their Christmas wishes and then compared them with the commercials that were being aired on TV at the time (Buijzen & Valkenburg, 2000). More than half the children requested at least one advertised product. Moreover, heavy exposure to television significantly predicted requests for more advertised products, even after controlling for age and gender of the child (see Figure 2.12). Another study of more than 900 5th and 6th graders found that those who watched a great deal of television had a more positive attitude toward junk food, such as sugared cereals and fast food items, than light viewers did (Dixon, Scully, Wakefield, White, & Crawford, 2007). Heavy TV viewers also perceived that other children ate junk food more often, and they perceived junk food to be healthier and reportedly ate more junk food themselves. These patterns held up even after controlling for gender, grade level, and socioeconomic status of the family.

Figure 2.11 Branded items marketed to youth.

Figure 2.12


SOURCE: Baby Blues © 1997 Baby Blues Partnership. Reprinted with permission of King Features Syndicate.

Among adolescents too, exposure to television has been linked to increased desire for products and brand names (Moschis, 1978; Moschis & Moore, 1979). However, evidence suggests that the strength of this relationship may decrease somewhat with age (Buijzen & Valkenburg, 2000; Robertson & Rossiter, 1977), consistent with children’s growing awareness of the purpose of advertising as well as increased skepticism about such messages.

Clearly, correlational evidence reveals that there is a relationship between TV advertising and product desire, but it is difficult to establish causality in such studies. It is possible that youth who are eager to buy toys, games, clothes, and snacks actually seek out television more often to find out about new products, a reverse direction in this relationship. Thus, researchers have turned to experiments to more firmly establish the impact of advertising.

In the typical experiment, children are randomly assigned to either view or not view an advertisement for a particular product. Afterward, children are allowed to select the advertised product from a range of other choices, or they are asked a series of questions about how much they like or want that product compared to others. Experiments generally show that commercials are indeed effective. In one study, preschoolers exposed to a single ad for a toy were more likely than those not exposed to (a) choose the toy over the favorite activity at the school, (b) select the toy even if it meant playing with a “not so nice boy,” and (c) choose the toy despite their mother’s preference for a different toy (Goldberg & Gorn, 1978). In a study of older children, exposure to a single ad for acne cream caused 4th and 5th graders to worry more about skin blemishes and want to buy the cream


(Atkin, 1976).

Although one ad can increase desire for a product, multiple exposures may be even more influential. Gorn and Goldberg (1977) found that viewing one versus three commercials was equally effective in increasing positive attitudes toward a new toy compared to a no-exposure control group, but only the three-exposure condition made children try harder to win the toy. Other research supports the idea that a single ad can increase awareness and liking of a product, but multiple exposures to varied commercials are most effective in changing consumer behavior (Gorn & Goldberg, 1980; Resnik & Stern, 1977).

Beyond repetition, there are other ways to enhance the impact of an advertisement. One tactic is to include a premium or prize with the product. In 1975, premiums were offered in nearly 50% of cereal ads targeted to children (Barcus, 1980). This practice is less common today in cereal ads, but fast food commercials routinely entice children with small toys that come with kids’ meals (Kunkel & Gantz, 1992). In 1997, McDonald’s had difficulty keeping Teenie Beanie Babies in stock once it began offering them as premiums in kids’ Happy Meals. Research suggests that premiums in commercials can significantly increase children’s desire for a product (Miller & Busch, 1979) and can actually affect children’s requests for cereals in a supermarket (Atkin, 1978).

Another strategy involves the use of a celebrity or a popular character to endorse a product in an ad. Professional athlete Michael Jordan has long been associated with Nike and even had athletic shoes (Air Jordans) named after him. There are countless other examples. Teen pop star Selena Gomez has her own clothing line, called Dream Out Loud, which is sold exclusively at Kmart (see Figure 2.13). Ellen DeGeneres is a spokesperson for JCPenney, and TV show Glee star Lea Michele was named 2012 Candie’s Girl to market a brand of shoes and apparel sold at Kohl’s. Even animated TV characters sell products—Bart Simpson claims to love Butterfinger candy bars.

Research supports the idea that popular figures can be effective sources of persuasion. One study found that teens perceived celebrities as more trustworthy, competent, and attractive than noncelebrity endorsers featured in nearly identical ads (Atkin & Block, 1983). Furthermore, the featuring of celebrities resulted in more favorable evaluations of a product. In a controlled experiment, Ross and her colleagues (1984) exposed 8- to 14- year-old boys to a commercial for a race car set but systematically varied


whether a celebrity endorser was included in the ad. The researchers found that exposure to the celebrity significantly enhanced boys’ liking of the racing set and increased their belief that the celebrity was an expert about the toy. In a more recent experiment, associating a healthy snack (i.e., fruit) with the TV character SpongeBob or Dora enhanced its appeal among preschoolers, up to the same level as that of candy (DeDroog, Valkenburg, & Buijzen, 2011).

Figure 2.13 Sample celebrity endorsement.

Taken as a whole, the research demonstrates that commercials can have quite powerful effects on children’s desires. Even a single ad can change the way a child perceives a toy or a game. Ads can also persuade young viewers to eat foods that are not very nutritious (see Chapter 7) and to try drugs such as tobacco (see Chapter 6). As it turns out, even a bland ad can make a product appealing (Resnik & Stern, 1977), but incorporating tactics such as premiums and celebrity endorsements can make a pitch even more effective. Next we will consider effects of advertising that are more indirect and not necessarily intentional on the part of advertisers: increased family conflict and changes in youth values.


Parent-Child Conflict Most advertising agency executives believe that TV commercials do not

contribute to family conflict (Culley, Lazer, & Atkin, 1976). Yet research suggests otherwise (see Figure 2.14). One study presented stories to elementary schoolers about a child who sees a TV commercial for an attractive product (Sheikh & Moleski, 1977). When asked if the child in the story would ask a parent to buy the product, nearly 60% of the children responded affirmatively. When asked what would happen if the parent said no, 33% of the children said the child in the story would feel sad, 23% said the child would be angry or hostile, and 16% said the child would persist in requesting the product. Only 23% indicated the child would be accepting of the decision.

Figure 2.14

SOURCE: © Tribune Media Services, Inc. All rights reserved. Reprinted with permission.

According to mothers, children’s attempts to influence purchasing occur with regularity, and this “nag factor” is perceived as stressful (Henry & Borzekowski, 2011). Mothers report that children ask most often for food items, especially cereals, snacks, and candy (Ward & Wackman, 1972).



Coincidentally, those same products are among the most heavily advertised to children. Requests for a parent to purchase something does seem to decrease with age (Ward & Wackman, 1972), in part because as children get older, they have more of their own money to make independent decisions. Yet for expensive items, even adolescents can pester parents. One national survey found that 40% of 12- to 17-year-olds had asked for an advertised product they thought their parents would disapprove of, and most of these young people said they were persistent (New American Dream, 2002). In fact, the teens estimated that they had had to ask an average of nine times before their parents gave in and made the purchase.

Several studies have actually observed parents and children shopping together in an effort to assess conflict more directly. In an early study, Galst and White (1976) observed 41 preschoolers with their mothers in a grocery store. The researchers documented an average of 15 purchase influence attempts (PIAs) by the child in a typical shopping trip, or one every two minutes! Most of the PIAs were for cereals and candy, and 45% of them were successful. In other words, the mothers acquiesced to nearly half of the children’s requests. In another observational study, Atkin (1978) found that open conflict occurred 65% of the time that a parent denied a child’s request for a cereal in a supermarket.

One experiment creatively linked PIAs directly to advertising. Stoneman and Brody (1981) randomly assigned preschoolers to view a cartoon that contained either six food commercials or no commercials at all. Immediately afterward, mothers were told to take their preschoolers to a nearby grocery store to buy a typical week’s worth of groceries, purportedly as part of another study. Posing as clerks in the store, research assistants surreptitiously coded the interactions that occurred. Children who had been exposed to the food commercials engaged in significantly more PIAs than children in the control group did. Children exposed to the commercials also made more requests for the foods featured in the ads. In addition, the mothers’ behavior was influenced by the commercials. Mothers of children who had seen the ads engaged in significantly more control strategies during the shopping trip, such as putting the item back on the shelf and telling the child no.

In sum, advertising can produce pressure on parents to buy products, which in turn can cause family conflict when such requests are denied. Younger children who confront parental resistance are likely to whine, become angry, and even cry (Williams & Burns, 2000). Older children, in



contrast, tend to use more sophisticated persuasion tactics, such as negotiation and white lies. There is some evidence of gender differences in this nag factor (Buijzen & Valkenburg, 2003a). Boys are more forceful and demanding in their requests than girls are, and boys also tend to be less compliant. Finally, research suggests that parent-child discord is not just an American phenomenon. One cross-cultural study found that heavy television viewing among children is linked to higher parent-child conflict about purchases in Japan and Great Britain as well as in the United States (Robertson et al., 1989).

Materialism and Value Orientations Critics worry that in addition to creating demand for certain products,

advertising may contribute more generally to materialistic attitudes in our youth. Materialism refers to the idea that money and possessions are important and that certain qualities such as beauty and success can be obtained from having material property. Fox (1996) argued that “when kids are saturated in advertising, their appetites for products are stimulated. At the same time, kids desire the values that have been associated with those products—intangible values that, like sex appeal, are impossible to buy” (p. 20). The popular Bratz dolls, for example, were marketed to tween girls as a “lifestyle brand” that revolved around makeup, sexualized clothing, and communal shopping and congregating at the mall (McAllister, 2007). In support of this materialism, or hyperconsumption, one national poll found that 53% of teens said that buying certain products made them feel better about themselves (New American Dream, 2002). Other critics argue that advertising should not be singled out for attack and that youthful consumerism is part of children’s participation in a larger culture that has become rooted in commodities and capitalism (Buckingham, 2011).

Disentangling advertising from all the other forces that might foster materialism is difficult, especially because nearly all children are exposed to a world filled with toy stores, fast food restaurants, movies, peer groups, and even schools, all of which promote consumer goods. Several correlational studies have looked to see if there is a relationship between media habits and materialism in youth. To measure materialism, students are typically asked to agree or disagree with statements such as, “It is really true that money can buy happiness” and “My dream in life is to be able to own expensive things” (see Table 2.2). One early survey of more than 800 adolescents found that heavy exposure to television was positively



correlated with buying products for social acceptance, even after controlling for age, sex, socioeconomic status, and amount of family communication about consumption (Churchill & Moschis, 1979). In this same study, teens who reported watching a lot of TV were also more likely to associate possessions and money with happiness. Another survey found a similar pattern for tweens (Buijzen & Valkenburg, 2003b). That is, 8- to 12- year-olds who frequently watched television commercials were more materialistic than were their peers who seldom watched commercials were. This was true regardless of the child’s age, gender, or socioeconomic status. More recently, a survey of 10- to 14-year-olds found that both heavy television exposure and high recognition of brand logos were independent predictors of higher materialism (Vega & Roberts, 2011). Trust in advertising also predicted more materialism among these preteens and teens.

Table 2.2 Sample Measure of Materialistic Orientation in Children

SOURCE: Adapted from Buijzen and Valkenburg (2003b). See http://www.ccam-

Such patterns are certainly suggestive, but they do not permit firm causal conclusions. Materialistic youth could seek out advertising, advertising might cause materialism, or both. Clearly, longitudinal research is needed to ascertain whether heavy exposure to advertising during early childhood


leads to more materialistic attitudes over time. As an example, Moschis and Moore (1982) surveyed 6th through 12th graders twice, across 14 months, about their exposure to television commercials and their materialistic attitudes. At Time 1, there was a significant association between exposure to ads and materialism, as has been found in other studies. Looking over time, exposure to advertising at Time 1 also predicted higher scores on materialism 14 months later at Time 2, but only among those youth who were initially low in materialism. In other words, television seemed to have its greatest impact on those who were not already highly materialistic. More longitudinal research of this sort is needed, particularly with younger children whose values are still developing. Obviously, studies also need to explore other relevant socialization factors, such as parents’ and peers’ values regarding material goods (Chia, 2010).

Another concern is whether advertising contributes to a preoccupation with physical appearance, especially among female adolescents. Teen magazines, in particular, are rife with ads featuring thin, attractive models (see Figure 2.15). Studies have found that female adolescents and college students do compare their physical attractiveness to models featured in advertising (Martin & Kennedy, 1993; Richins, 1991). Moreover, looking at ads of highly attractive models can temporarily affect self-esteem and even body image (Stice & Shaw, 1994), especially among girls who are encouraged to evaluate themselves (Martin & Gentry, 1997). In one experiment, adolescent girls who were exposed to a heavy dose of commercials emphasizing physical appearance were more likely to believe that being beautiful is an important characteristic and is necessary to attract men than were those in a control group exposed to other types of ads (Tan, 1979).

Figure 2.15 Covers of popular teen magazines.


Longitudinal evidence is beginning to emerge here as well, suggesting that early television and magazine exposure increases young girls’ desire to have a thin body (Harrison & Hefner, 2006) and young boys’ desire to have a muscular body (Harrison & Bond, 2007) when they grow up.

Phases of Consumer Behavior During Childhood Valkenburg and Cantor (2001) outlined four phases of consumer development in childhood, which provide a nice overview of much of the material covered in this chapter so far. The first phase, which they call “Feeling Wants and Preferences,” characterizes infants and toddlers. During this phase, young children show distinct preferences for smells, colors, sounds, and objects, an important component of consumer behavior. Still, at this young age, children are primarily reactive rather than goal directed, so they are not capable of acting like true consumers.

The second phase, “Nagging and Negotiating,” captures the preschool years. As we have noted above, preschoolers have difficulty distinguishing ads from programs and do not fully comprehend the intent of commercials. Consequently, Valkenburg and Cantor (2001) argue, marketing efforts have a strong impact on this age group. Because of preschoolers’ tendency toward centration (see Chapter 1), they are likely to gravitate toward products that are visually striking. They also immediately want what they see, so they are most likely to pester parents and to exhibit noncompliant and emotional behavior when they are denied something.



Phase 3, “Adventure and the First Purchase,” characterizes the early elementary school years, between the ages of 5 and 8. Cognitive abilities are in transition here as children gradually consider more conceptual information, become more responsive to information presented verbally, and increase their attention span. But this age group can still be confused about the purpose of ads and can still respond strongly to perceptual cues. Children typically make their first solo purchase during this phase, thus becoming a bona fide consumer independent of a parent.

Phase 4, “Conformity and Fastidiousness,” marks the tween years, from 8 to 12. The ability to critically evaluate information, compare products, and appreciate the selling intent of ads develops during this time. Because of their attention to detail and quality, many children become serious collectors of objects during this period. Tweens show a strong sensitivity to the norms and values of their peers as well as to what older adolescents are buying and doing. Most tweens regularly visit different types of stores, making independent purchases and influencing household buying practices. In other words, by late elementary school, all the fundamentals of consumer behavior are in place (i.e., the child shows preferences, can evaluate options, and can choose and purchase a product).

Although Valkenburg and Cantor (2001) did not identify a Phase 5, they noted that consumer skills continue to develop during adolescence, which is consistent with research described earlier in this chapter. In particular, teens are increasingly able to recognize bias, and they are more skeptical of commercial messages. However, their preoccupation with identity development means that they pay close attention to self-presentation and peer acceptance, which in turn can make them susceptible to brand-related social status messages in the commercialized world (Buijzen, Van Reijmersdal, & Owen, 2010).

Marketing Strategies in the 21st Century As children’s and teens’ spending power increases, marketers are continually experimenting with new ways to reach young consumers. Large corporations such as Coca-Cola, McDonald’s, and KFC are developing a variety of digital marketing tactics to reach tweens and teens as they spend countless hours with screen media. The idea is to capitalize on the fact that young people today are constantly connected to devices, yearn for personalized messages, prioritize opportunities to network with peers, and



enjoy immersive digital environments (Montgomery & Chester, 2009). In this section, we will examine five techniques that are burgeoning in the 21st century: character merchandising, product placement, viral marketing, online marketing, and marketing in schools.

Character Merchandising Character merchandising refers to the licensing of popular characters to

promote many types of products (Institute of Medicine, 2006). Using characters to build brand loyalty is not a new phenomenon. Mickey Mouse was created in 1928 by Walt Disney, and today the anthropomorphized creature is an international icon. Similarly, the promotion of toys that are based on popular programs is a marketing strategy that has been around for a while, as discussed earlier in this chapter. As early as 1969, the cartoon Hot Wheels was criticized as nothing more than a 30-minute commercial for Hot Wheels toys (Colby, 1993). Roughly 20 years later, the Teenage Mutant Ninja Turtles cartoon helped to sell more than $500 million worth of toy merchandise in 1990 alone (Rosenberg, 1992).

Nowadays, however, characters are being used in a more integrated fashion across media platforms. Consider the Pokémon craze (see Figure 2.16). The cute pocket-sized monsters originated in 1996 in Japan as characters in a Nintendo video game. In 1998, U.S. marketers simultaneously launched a TV cartoon series, trading cards, a video game, and toy merchandise. Later came party products, a Warner Brothers motion picture, a CD, children’s apparel sold at JCPenney, kids’ meal premiums at Burger King, and even Pokémon tournament leagues that met weekly at Toys‘R’Us to play the video game (Annicelli, 1999; Brass, 1999; Jones, 2000). The Pokémon franchise explicitly reinforces the idea that the best way to become cool is to collect as many monsters as possible. Apparently, children have been convinced. Within the first 10 years after its 1996 launch, the franchise generated $26 billion in retail sales and sold more than 155 million Pokémon video games worldwide (Graft, 2007). And there is no end in sight to the pocket monsters’ popularity. In 2010, 153 new characters were unveiled as Nintendo released its fifth generation of games, Pokémon Black and Pokémon White, designed for the Nintendo DS. On the first day of availability in the U.S., more than 1.08 million copies were sold (Pereira, 2011). In 2012, Nintendo released the very popular sequels Pokémon Black 2 and Pokémon White 2. Films, music recordings, and trading cards have accompanied each of these game releases.



Figure 2.16 Character merchandising: The Pokémon craze.

Such tactics do seem to blur the differences between advertising and entertainment content. Toy-based cartoons, for example, have been criticized as “animated sales catalogs masquerading as entertainment” (Waters & Uehling, 1985, p. 85). One of the challenges for young viewers is that toy-based cartoons feature the same popular characters, slogans, and sound effects that are employed in related commercials for the toys. Several studies reveal that the combination of a cartoon and related advertising can be very confusing for young children (Hoy, Young, & Mowen, 1986; Kunkel, 1988). For example, Wilson and Weiss (1992) found that 4- to 6-year-olds were less able to recognize an ad for a Beetlejuice toy or comprehend its selling intent when it was shown with a Beetlejuice cartoon than when it was shown with an unrelated Popeye cartoon. Moreover, the confusion occurred regardless of whether the related Beetlejuice cartoon was immediately adjacent to the ad or separated from it by five minutes of filler material. This finding is consistent with younger children’s perceptual dependence, as discussed in Chapter 1.

Interestingly, the evidence is mixed on whether airing ads together with related programming is a good marketing strategy. Some studies have found


that this technique enhances children’s desire for a product (Kunkel, 1988; Miller & Busch, 1979), whereas others have not (Hoy et al., 1986; Wilson & Weiss, 1992). Success presumably depends in part on the nature of the product as well as the popularity of the related character.

Thus, as commercials increasingly resemble TV programs and popular characters appear in movies, on cereal boxes, as toys, on websites, in CDs, and in video games, the young child is likely to become even more confused about what advertising actually is. On occasion, even sophisticated consumers may feel bewildered or perhaps overwhelmed by these multimedia character merchandising endeavors.

Product Placement Product placement is a promotional tactic used by marketers whereby a

commercial product is placed in a visible setting outside a typical marketing context. The most common product placement occurs in movies, where a corporation will typically pay to have its product used by the characters. Candy sales shot up by 66%, for example, when Spielberg’s movie character E.T. was shown eating Hershey’s Reese’s Pieces (Mazur, 1996). Product placement on television has become popular in recent years too, especially because consumers are using newer digital recording technologies such as TiVo to skip over commercials. Reality TV shows in particular have become known for their use of brand-name products in helping people to redesign their homes, their gardens, and even their love lives. For example, the Coca-Cola Company paid $10 million in 2002 to have Coke served to the judges on American Idol (Howard, 2002).

Unlike reality shows, children’s programs have avoided product placement so far, presumably because of the separation principle. This principle, established by the Federal Communications Commission (FCC) in 1974, mandates that there must be a clear distinction between program and advertising content during shows targeted to children (see discussion on advertising policy in Chapter 13).

The idea behind product placement is to have a product fit seamlessly into the context of a story or program. This subtle technique is an effort to build brand loyalty without calling attention to the persuasive intent of the strategy. Some have referred to these types of tactics as “stealth marketing” because the consumer is unaware that it is an attempt to influence purchasing behaviors (Institute of Medicine, 2006).



Product placement also occurs when websites have sponsors that place their logos on the page. The TeenNick website (, for example, has a box or banner on the top of the homepage that is used for rotating commercial messages. Recently, for example, there was an image of Clearasil products prominently placed at the top, with the accompanying message “Click to Learn More.” The link was not explicitly labeled or identified as an advertisement.

Advertisers have also developed “advergames,” which are online video games with a subtle or overt commercial message. For example,, a website hosted by various candy companies, features dozens of games, including one called Gummi Grab involving Gummi Bears and another called Trident Layers Factory involving stacks of chewing gum. While playing these games, the user is exposed to multiple images of such candy, purportedly helping to build brand loyalty. In fact, the brands are often used as tools or equipment for playing the game, making the commercial nature of the game imperceptible or somewhat concealed (Lee, Choi, Cole, Quilliam, & Cole, 2009). Moreover, games on for-profit websites rarely contain nutritional or health-related information (Cicchirillo & Lin, 2011; Culp, Bell, & Cassady, 2010). One study of 77 food-related websites targeted to children found a total of 546 different games containing food brands on these sites (E. S. Moore, 2006).

Like character merchandising, product placement blurs the traditional distinction between commercial content and entertainment content. Individuals confronted with these types of embedded messages need to comprehend the film’s storyline or learn to play the game, so they have fewer cognitive resources available to process the coexisting commercial branding (Owen, Hang, Lewis, & Auty, 2012). Even adults are not always aware of such brand exposure (Yang, Roskos-Ewoldsen, Dinu, & Arpan, 2006). As we have discussed above, such covert strategies are likely to make it even more challenging for young children who already struggle to identify and comprehend advertising. Because such tactics are subtle, they may also go unnoticed by older children and teens who ordinarily could muster their cognitive defenses in the face of overt commercial persuasion. As a demonstration of impact, a recent experiment found that children who played Pop-Tarts and Oreo advergames were more likely to select unhealthy snack foods than were those who played either Dole-sponsored (“healthy”) games or nonfood games (Harris, Speers, Schwartz, & Brownell, 2012). Moreover, no age differences were observed among the 7- to 12-year-olds in the study. In other words, both younger and older children were affected


by the placement of unhealthy food products in the advergames. Another recent experiment confirms the idea that food images in advergames can increase unhealthy snacking in children (Folkvord, Anschutz, Buijzen, & Valkenburg, 2013).

Viral Marketing Viral marketing is another form of “under-the-radar” or stealth marketing

(Institute of Medicine, 2006). This term refers to the “buzz” or “word of mouth” about a product that occurs when people talk about it. Marketers use various techniques to stimulate buzz about a product, from paying trendsetters to use a product and talk about it to creating a blog to encourage online chat about a product (Calvert, 2008). For example, music industry marketers have used this approach by sending attractive young consumers into music stores to talk about a new CD to each other, knowing that unsuspecting customers will overhear the conservation (Kaikati & Kaikati, 2004).

Stimulating buzz is not an accident—such campaigns are meticulously engineered and the results are carefully measured (Khermouch & Green, 2001). In 2007, Webbed Marketing, an agency specializing in viral marketing, announced the release of the Webbed-O-Meter (“Viral Marketing Agency,” 2007). The tool measures the amount of buzz surrounding any website, which consists of all the online references made to that site by Internet consumers, bloggers, analysts, reviewers, and reporters. Today, there are many agencies as well as software and dashboards (e.g., Trendiction, HootSuite) that can track the success of viral marketing (J. Wethall, personal communication, September 10, 2012).

Viral marketing is thought to be particularly effective with young, trend- conscious consumers who want to be first among their peers to have new products and wear new fashions (Khermouch & Green, 2001). Finding the right individuals to stimulate the buzz, then, is part of the challenge. Companies often recruit popular teens, called “connectors,” through a company website, through YouTube videos, through Twitter, or by monitoring online chat rooms related to teen culture (Dunnewind, 2004). Sometimes marketers “seed” an idea or a brand in targeted blogs, videos, or tweets with the hope that these seeds will be picked up by other bloggers/video channels/tweeters and blossom into a message that goes viral. Downloadable widgets are also popular with adolescents—they can be used to personalize a webpage, but they also allow marketers to track



user responses (Montgomery & Chester, 2009).

An offshoot of viral marketing is called “guerrilla marketing” (Levinson, 2007), which is typically a low-cost, unconventional strategy designed to capture people’s attention, create buzz, and hopefully turn viral. Flash mobs are one example of this technique. The lap dance that Eninem received during the MTV Movie Awards in 2009 is another example. Companies can engage in guerrilla marketing too. To advertise Super Glue-3, marketers glued coins on various city sidewalks. When people tried to pick up the coin, they saw a small logo for the product glued next to the irremovable coin. This street marketing tactic was later picked up on YouTube (see

Viral marketing is frequently one component of an integrated marketing communications campaign. But many believe it will become increasingly more common as marketers struggle to reach consumers in a media landscape composed of hundreds of television channels. In addition, marketers recognize that young people use the Internet a great deal, frequently download applications on their smartphones, are often cynical about 30-second TV ads, and are greatly influenced by peers.

Yet viral marketing is also controversial. Critics charge that it is an insidious form of commercialism because marketers are working at the grassroots level, manipulating people’s social relationships with these relatively inexpensive ploys (Khermouch & Green, 2001; Minow, 2004). There is also concern that such techniques may come under regulatory scrutiny because consumers can be misled about the commercial relationship that often exists between the connectors and the corporations sponsoring their activities (Creamer, 2005). According to the basic principle of advertising, people should know they are being solicited for commercial purposes.

Online Marketing to Youth Millions of American children and teens go online each week, and there

are countless websites to attract them (see Chapter 8). In fact, several lists exist to help parents and children identify websites designed just for young people, including,, and Interestingly, the five most popular websites among children revolve around television:,,, (Club Penguin), and (see



Table 2.3).

As anyone who goes online knows, the Internet is filled with advertising. In fact, Internet ad spending worldwide is projected to be $98 billion for 2012, representing a 16% increase from the year before (Hof, 2012). Moreover, in the first quarter of 2012, the growth rate for ad spending on the Internet surpassed that for other forms of media, which for the most part also showed an increase (see Table 2.4). Magazines are the only medium where ad spending dropped compared to the year prior.

Many online commercial messages are targeted directly to children. Banners lure children to commercial websites to advertise and sell products. And websites for children often blend commercialism with content in ways that make them indistinguishable from each other (Cai & Zhao, 2010). For example, one study found that over 80% of popular children’s websites featured character spokespersons on their homepages, in ads, and/or in the games that could be played (Bucy, Kim, & Park, 2011). In addition, only about one in four of the websites that employed such characters in advertising explicitly labeled the content as commercial in nature. Many branded products targeted to youth have websites that are created to supplement traditional forms of advertising. These “branded environments” are relatively cheap to maintain and typically feature a range of activities, such as games, polls, quizzes, and guestbooks. For example, the Crayola website offers the child user a variety of games to play, crafts to make, and links to Crayola applications that can be downloaded to mobile devices. Of course, the site also sells Crayola products.

Table 2.3 Most Popular Kids’ Websites in September 2012


SOURCE: The 15 most popular kids’ websites per eBizMBA’s ranking, which is a constantly updated average of each website’s Alexa Global Traffic Rank and the U.S. Traffic Rank from both Compete and Quantcast (

Several websites entice children to enter virtual worlds that involve products. The Webkinz website is an example of this craze ( One journalist has likened it to “Beanie Beanies in cyberspace” (Hawn, 2007). The company sells Webkinz plush animals and the newer, smaller Lil’Kinz animals for anywhere between $10 and $25 apiece. Each animal comes with a “secret code” that allows the child to enter the Webkinz website, where the animal comes to life and can be adopted, named, exercised, and fed (see Figure 2.17). The child can also play games to earn “KinzCash,” which can be used to buy the animal toys, clothes, and furniture. Children can even talk online with their friends using KinzChat. When the toys were first introduced in 2005, retailers had difficulty keeping them in stock. In 2008, e-commerce data revealed that the term “Webkinz” was searched more than 3.5 million times in a single month, making it the top product searched for during September, ahead of “Wii” and even “Halloween costumes” (Deatsch, 2008). Suffice it to say that children are likely to have trouble discerning what is and is not advertising in these online environments. In one creative study, researchers designed a


variety of webpages that included commercial content and asked over 400 children to point to whatever they thought was an advertisement (Ali, Blades, Oates, & Blumberg, 2009). As a comparison, adults were almost perfectly accurate in identifying all the ads on the pages. In contrast, 6-year- olds recognized only 25% of the ads, 8-year-olds recognized about 50%, and 10- to 12-year-olds recognized 75% of the ads. The inclusion of price information in some of the ads did little to help the two younger groups, demonstrating how confusing website commercialism can be. Some critics have called for limiting ads to fixed positions (e.g., upper right corner) or including bridge windows or pages to “physically” separate ads from content on webpages designed for children (Cai & Zhao, 2010).

Table 2.4 Change in Global Spending on Advertising by Media From 2011 to 2012

SOURCE: Nielsen Global AdView Pulse report, 2012, Q1, from Hof (2012).

Unlike other media, the Internet also allows marketers to collect personal information from individuals to be used in promotional efforts, market research, and electronic commerce. And this worries parents. According to a national survey, 73% of parents with home Internet connections are nervous about websites having their personal information, and 95% believe that teenagers should have to get their parents’ consent before giving out information online (Turow, 2003). Research suggests that parents need to be vigilant. One study of 133 websites popular with children found that 87% collected personal information from the user such as name, e-mail address, birth date, and postal address (Cai & Zhao, 2010). In an earlier study of over 160 websites for kids, roughly 15% of the sites that requested personal information asked for a credit card number (Cai, Gantz, Schwartz, & Wang, 2003). Most alarming, two-thirds of the sites requesting information made


no effort to persuade the child to obtain parental permission first.

Figure 2.17 Homepage for the Webkinz website.

SOURCE: ©2005–2007 GANZ. All rights reserved.

Recognizing these problems, Congress passed the Children’s Online Privacy Protection Act (COPPA) in 1998, to be enforced by the Federal Trade Commission (FTC). The law requires that all websites targeted to children younger than 13 must have a prominent link to a privacy policy that clearly identifies how personal information is collected and used. Despite this ruling, some children’s websites still do not post a privacy policy, and many that have one do not make the link very prominent or the policy itself very accessible or readable for parents (Cai & Zhao, 2010; Turow, 2001). In the content analysis of popular children’s websites described above (Cai et al., 2003), only 4 of the 162 websites were in full compliance with COPPA. It should be noted that COPPA does not apply to websites targeted to youth over the age of 12, even though parents are concerned about privacy protection for teens as well (Turow, 2003).

Even with explicit policies in place, one of the challenges is that marketing strategies keep changing. Recently, a number of child advocacy groups filed a complaint with the FTC, asserting that several well-known websites aimed at children, such as and, were


encouraging children to provide a friend’s email address—without seeking parental consent (Singer, 2012). Such “Tell a friend” or “Play this game and share it with your friends” messages are a powerful form of viral marketing using an online platform. As new tactics evolve, the FTC will have to determine how to apply COPPA rules to these innovations.

Even still, a privacy policy such as COPPA may not be enough to protect families. In a national survey of 10- to 17-year-olds, 31% reported that they had given out personal information to a website (Turow & Nir, 2000). Moreover, 45% of the youngsters said they would exchange personal information on the Web for a free gift, and 25% reported never having read a site’s privacy policy. In addition, there is some evidence that a warning about age restrictions for membership on a website may actually increase preteens’ willingness to disclose personal information (Miyazaki, Stanaland, & Lwin, 2009). Thus, it seems reasonable to conclude that as long as marketers are free to collect information about users regardless of age, the Internet will be a relatively easy way to discover and try to influence the consumer preferences of youth.

Marketing in Schools Commercialism in schools has soared in recent years, spurring much

public debate about the ethics of such practices (Molnar, Boninger, & Fogarty, 2011). Corporations are eager to partner with schools as a way to reach young consumers, who spend almost 20% of their time in the classroom. In turn, public schools often feel desperate to augment tight budgets, and corporate support offers one way to do so.

Four types of commercial practices can be found in various degrees across American schools (Consumers Union Education Services, 1995; Wartella & Jennings, 2001). First, marketers often advertise directly to students by placing ads on school billboards, buses, or athletic scoreboards, and even in student newspapers and yearbooks (see Figure 2.18). Second, corporations occasionally give away products or coupons to expose children to different brand names. For example, Minute Maid, McDonald’s, and Pizza Hut have offered food coupons to students who meet their teachers’ reading goals.

Third, corporations frequently sponsor fund-raisers to help schools afford new equipment, uniforms, or class trips. Students themselves become marketers in these efforts, approaching aunts and uncles, neighbors, and



even parents’ work colleagues. Pitching anything from poinsettia plants to gift wrap to frozen pizzas, students can earn prizes for themselves and money for their school. In a particularly troubling example, Kohl’s department stores ran a “Kohl’s Cares for Schools” contest during the summer and fall of 2010 (Molnar et al., 2011). To win the race for a $500,000 prize, schools engaged in a variety of activities to gather votes on Facebook, including setting up booths at local community events and creating YouTube videos. The 20 schools with the most votes won the contest, and everyone who voted was put on Kohl’s mailing list to receive advertisements and promotional messages.

Fourth, marketers often create educational materials such as workbooks, brochures, and videos on specific curriculum topics. For instance, Shell recently partnered with Scholastic Inc. to produce an “Energize Your Future” curriculum that focused on the importance of producing multiple energy sources and linked Shell to such activities (Molnar et al., 2011). Unfortunately, one study found that nearly 80% of these corporate-sponsored materials contained biased or incomplete information (Consumers Union Education Services, 1995).

A fifth and more controversial form of commercialism in schools is Channel One, a 12-minute daily news program designed for middle and high school students. Introduced in 1990 by Whittle Communications, the program includes 10 minutes of originally produced news for teens and two minutes of advertising. Schools sign a three-year contract that provides them with a dedicated satellite transmission system, a satellite dish, television sets and other display converters in certain classrooms, a preview monitor, and all wiring and maintenance for the equipment. In exchange, a school agrees to show Channel One News on at least 90% of the days that the school is in session. Roughly 7,000 American middle and high schools have entered into this contractual arrangement (Channel One News, n.d.).

Figure 2.18 Advertising in schools.



Channel One has been challenged on several fronts. Critics have charged that the arrangement cedes control of the curriculum to outside parties, requires students to be a captive audience to ads, and exposes students to messages that run counter to nutritional lessons taught in school (Consumers Union Education Services, 1995). Amid the controversy, several advertisers, such as PepsiCo and Cingular, decided to pull their advertising from the newscast, and the network has struggled financially in recent years (Atkinson, 2007).

Research supports some of the criticisms that have been lodged against Channel One. A study by Brand and Greenberg (1994) found that, compared with nonviewers, students exposed to Channel One gave more favorable ratings to products that were advertised during the newscast. Viewers also expressed more materialistic attitudes than nonviewers did. On the positive side, viewers did seem to learn more about news, particularly those events covered in the daily programs (Greenberg & Brand, 1993).

A similar initiative in Canada, called Youth News Network (YNN), had minimal success. This corporate initiative promised audiovisual and computer equipment to schools in exchange for showing a 12.5-minute newscast that included 2.5 minutes of ads. The service was banned in every


Catholic school in Canada and in 6 of the 13 provinces. A report by the Canadian Centre for Policy Alternatives concluded that

having a corporate presence in the classroom is tantamount to giving such companies school time—and the public money which pays for that time—in which to advertise their products to kids. Our taxes are literally paying for the commercial targeting of our students, and diverting time and money from their education. (Shaker, 2000, p. 19)

Today, nearly 5 million American teens watch advertising on television each day in the classroom (”Who Are We?” 2012). Other students enter contests, receive curriculum materials, and are exposed to hallway ads that promote products. Some believe these arrangements represent innovative ways to support struggling schools (see Richards, Wartella, Morton, & Thompson, 1998). Others view this growing trend as a violation of “the integrity of education” (Consumers Union Education Services, 1995). Regardless of which view is taken, such practices are likely to continue as marketers search for creative ways to reach youth.

Teaching Advertising Literacy Recognizing the difficulty of changing the advertising environment in the United States, some have called for efforts to teach children how to be more critical consumers. As it turns out, even older children who clearly recognize the selling intent of ads do not typically critique commercials spontaneously while viewing them (Brucks, Armstrong, & Goldberg, 1988; Derbaix & Bree, 1997). In other words, their general skepticism toward advertising is not always activated when they actually encounter commercial messages. One study suggests that a simple cue or reminder can trigger a viewer’s cognitive defenses, raising the number of counterarguments that older children produce during exposure to commercials (Brucks et al., 1988).

Other studies have explored more formal training procedures to help children deal with advertising. Roberts, Christenson, Gibson, Mooser, and Goldberg (1980) compared two 15-minute instructional films designed to teach children about commercials: The Six Billion $$$ Sell, which focused on tricks and appeals used in ads, and Seeing Through Commercials, which focused on how ads are made. Second, third, and fifth graders were randomly assigned to view one of the two films or a control film unrelated



to advertising. Results revealed that the treatment films increased children’s general skepticism toward advertising as well as their ability to be critical of specific ads. The strongest effects were observed for The Six Billion $$$ Sell, the film that detailed specific strategies and showed ad examples. Moreover, the youngest participants, who initially were far more accepting of advertising, learned the most from the films.

Christenson (1982) used excerpts from The Six Billion $$$ Sell to create a three-minute public service announcement (PSA) about the nature of advertising. One group of children saw the PSA before watching cartoons embedded with ads, whereas another group simply watched the content without the PSA. The insertion of the PSA increased 1st and 2nd graders’ comprehension of the selling intent of ads, and it enhanced skepticism about ads among this younger age group as well as among 5th and 6th graders. Furthermore, the PSA actually lowered children’s taste ratings of two food products advertised during the cartoons.

Instruction that is more traditional can teach children about advertising as well. One study found that half-hour training sessions over the course of several days were effective in teaching children as young as 6 how to detect persuasive tricks and strategies in ads (Peterson & Lewis, 1988). In another study, Donohue, Henke, and Meyer (1983) compared two types of instruction: role playing, which had children assume the role of an advertiser to create a commercial, and traditional, which had children watch TV ads and discuss the purpose and nature of commercials. Compared with a control group, both treatments helped 1st graders to better discriminate ads from programs and to be more skeptical of commercials. However, only the traditional instruction increased children’s understanding of the persuasive intent of advertising.

Conceptual knowledge of advertising, however, does not necessarily mean that children use this information when they are confronted with a highly attractive commercial message. Rozendaal, LaPierre, van Reijmersdal, and Buijzen (2011) point out that children typically process ads under conditions of “low elaboration,” meaning that they do not critically evaluate the content of the message. In fact, because most commercial messages contain little information and instead are high in emotional appeal, they actually foster shallow processing. Under such conditions, children have difficulty engaging in the “stop-and-think” response that is needed to defend oneself against a persuasive message (Rozendaal, LaPierre, et al., 2011). In other words, children who are still


maturing lack the ability to retrieve their advertising-related knowledge and apply it to a commercial message while they are simultaneously trying to make sense of the message. Such reasoning is consistent with the growth in processing capacity and executive functioning that occurs during childhood and adolescence, as described in Chapter 1.

In support of this idea, the researchers conducted a study in which 8- to 12-year-old children watched a brief TV show that contained a commercial for Lays potato chips (Rozendaal, Buijzen, & Valkenburg, 2012). Children were told either to think aloud while watching the video, stating everything that came to mind, or to write down all the thoughts they had after watching. There was no difference between the two conditions in terms of the number of critical thoughts children had about the commercial. However, the think- aloud method was more effective in decreasing children’s desire for the advertised product. The researchers argued that both groups possessed the knowledge about advertising (based on the number of critical thoughts produced), but that only the think-aloud procedure help children apply that critical stance while viewing.

In addition to formal and informal instruction, it turns out that parents can help in a number of ways, too (see Figure 2.19). One experiment found that simply reducing grade school children’s television and video game use for six months decreased their toy purchase requests compared to those of a control group that did not change media habits (Robinson, Saphir, Kraemer, Varady, & Haydel, 2001). Parents also can talk to their children about the nature of commercials and how to evaluate them. Such discussion can improve younger children’s understanding of the purpose of advertising (Ward et al., 1977). Critically discussing commercials with a parent can also reduce children’s consumption of advertised foods (Buijzen, 2009) and is associated with fewer purchase requests and less materialism in elementary schoolers (Buijzen & Valkenburg, 2005). One caveat is in order here: Parents need to take into account the difficulty children have in applying what they know when faced with an onslaught of emotionally appealing commercial messages. Parents who watch TV or surf the Internet with their children can help activate such critical thinking.

Parental discussion even seems to benefit adolescents. Teens who talk with their parents about consumption show a higher knowledge of prices (R. L. Moore & Stephens, 1975) and more discriminating behavior when making purchases (Moschis & Churchill, 1978). Teens whose parents encourage critical thinking also show more concern about divulging privacy


information on the Internet (Moscardelli & Divine, 2007). As with other types of media content (see Chapter 12), parental mediation can play an important role in preparing youth for daily encounters with commercial messages.

Figure 2.19

SOURCE: Reprinted with permission from Tribune Media Services.

Conclusion Children are born to become consumers in the United States. They typically visit their first store at the tender age of 2 months, and by the time they reach 2 years, most have made a request for a product (McNeal, 2007). Their bedrooms are filled with Disney characters, designer crib sheets, and Baby Gap clothes, and their playrooms are stuffed with all kinds of toys. By the time children reach preschool, they are watching their favorite toy-based



cartoons, seeing several hours’ worth of TV advertising each week, and making regular trips with a parent to the grocery store, fast food restaurants, and Toys‘R’Us. All of this exposure comes at a time when children are very naive about commercial messages and trusting of their content.

As children reach the early elementary school years, they gradually learn about the motives behind advertising and the tactics used in commercials. Some of this knowledge helps them to become more skeptical of such messages. Yet keeping these cognitive defenses in mind is not always easy for them when they confront a slick and highly entertaining commercial suggesting that everyone else has a particular new toy. Certainly, television is not the only source of these desires. School-aged children may be most vulnerable when commercialism invades their classroom, becoming part of the decor or even the curriculum itself. And spending time online and with mobile devices such as smartphones may confuse children even more, as marketing becomes intimately intertwined with noncommercial content.

In the face of all this commercialism, some critics have argued that advertising is inherently unfair to young children and ought to be eliminated from content targeted to those younger than age 8. An opposite position holds that children will never learn to be consumers unless they are exposed to commercial messages. A third intermediary position is that parents and educators need to develop ways to help youth become more critical consumers. As children’s discretionary income grows and they spend more time surfing websites, wandering in shopping malls, and watching TV on personal laptops and alone in their bedrooms, early training in critical consumer skills seems crucial.

Exercises 1. Find a magazine advertisement targeted to children. What type of

product is being advertised? Does it fit into one of the top four categories of children’s ads found on television (see the Kunkel & Gantz, 1992, study above)? What is the main appeal used in this ad to persuade children? Is there any disclaimer offered in the ad? If so, is it likely to be noticed or understood by a child? Is there anything in the ad that might be misleading or confusing for a 5-year-old child? For a 10-year-old child?

2. Find a magazine ad targeted to teens. What type of product is being


advertised? Do you see evidence of gender or racial stereotyping in the ad? What is the main appeal used in the ad? Is there anything about the ad that might make teens feel self-conscious about their own physical appearance?

3. Think about your childhood. What is the first toy purchase you remember feeling disappointed about? How old were you? Did you buy the toy with your own money? Did advertising have anything to do with your disappointment? How did your mother or father respond to your disappointment? Did your parents discuss advertising with you?

4. Since the late 1990s, Sweden has not allowed advertisements to air immediately before, during, or after a television program oriented primarily to children under 12 years of age. Do you think such a ban is a good idea in the United States? Why or why not? Instead of an all-out ban, can you think of any other types of regulation of children’s advertising that might be easier to enact in the United States?

5. Find two popular websites for children, one that is highly commercialized and one that is not. For example, you could compare the Barbie site ( with a site called Math for Kids (, which is designed to teach children math lessons. Design a coding scheme that allows you to answer the following: How much advertising is on each website? Are there features of the sites that look like content but are actually ads? Do the sites ask children for personal information? If so, is there a privacy policy? Critique each site, thinking about a 9-year-old user without a parent in the room.

6. Harry Potter is an example of a remarkably successful brand story. A total of seven books have been published about the boy wizard, and eight live-action movies have been made. In addition, there have been hundreds of tie-in products made available for purchase, from candy to computer games. List as many examples as you can that reflect how this book series has been commercialized across different media. Have you ever spent any money on Harry Potter products? When you were a child, was there any movie you can remember that was similarly successful? What has changed in the past 20 years regarding the promotion of media stories and their characters? Find a current successful brand story and compare it to the Harry Potter franchise in terms of commercialization, success, and target audience.

7. You are a principal of a large high school in a rural area. Your school


band has been invited to perform in Washington, DC, and your basketball team is ranked highly in the state. But the band desperately needs new uniforms, and the basketball team needs new athletic equipment, both of which are not in your budget. You are approached by the head of B&W Marketing, who offers you $100,000 in exchange for placing a select number of advertisements in school hallways. What should you do? What factors should you consider in making your decision?

8. Using all the research cited in this chapter, design a video that would help teach a 6-year-old about commercial advertising in today’s society. What skills should you focus on? How will your video cover different media (e.g., television, Internet)? How will you help children to apply what they learn when they actually encounter commercial messages? Now imagine that you need to design a video for 10-year-olds. How will the content of your video change?


Adler, R. (1980). Children’s television advertising: History of the issue. In E. L. Palmer & A. Dorr (Eds.), Children and the faces of television: Teaching, violence, selling (pp. 237–248). New York, NY: Academic Press.

Alexander, A., Benjamin, L. M., Hoerrner, K., & Roe, D. (1998). “We’ll be back in a moment”: A content analysis of advertisements in children’s television in the 1950s. Journal of Advertising, 27(3), 1–9.

Ali, M., Blades, M., Oates, C., & Blumberg, F. (2009). Young children’s ability to recognize advertisements in web page designs. British Journal of Developmental Psychology, 27, 71–83.

Annicelli, C. (1999, June). Monster cash; Pokémon has made a fortune; Prepare for the second wave. Retrieved from

Atkin, C. K. (1976). Children’s social learning from television advertising: Research evidence on observational modeling of product consumption. Advances in Consumer Research, 3, 513–519.

Atkin, C. K. (1978). Observation of parent-child interaction in supermarket decision-making. Journal of Marketing, 42(4), 41–45.

Atkin, C. (1980). Effects of television advertising on children. In E. L.


Palmer & A. Dorr (Eds.), Children and the faces of television: Teaching, violence, selling (pp. 287–305). New York, NY: Academic Press.

Atkin, C. (1982). Television advertising and socialization to consumer roles. In D. Pearl, L. Bouthilet, & J. Lazar (Eds.), Television and behavior: Ten years of scientific progress and implications for the eighties (Vol. 2, pp. 191–200). Washington, DC: Government Printing Office.

Atkin, C., & Block, M. (1983). Effectiveness of celebrity endorsers. Journal of Advertising Research, 23(1), 57–61.

Atkinson, C. (2007, April 23). Kicked out of class: Primedia sheds in- school net. Retrieved from

Autherland, A., & Thompson, B. (2003). Kidfluence: The marketer’s guide to understanding and reaching Generation Y—kids, tweens, and teens. New York, NY: McGraw-Hill.

Bakir, A. (2009). “Some assembly required”: Comparing disclaimers in children’s TV advertising in Turkey and the United States. Journal of Advertising Research, 49(1), 93–103.

Barcus, F. E. (1980). The nature of television advertising to children. In E. L. Palmer & A. Dorr (Eds.), Children and the faces of television: Teaching, violence, selling (pp. 273–285). New York, NY: Academic Press.

Batada, A., & Borzekowski, D. (2008). Snap! Crackle! What? Recognition of cereal advertisements and understanding of persuasive intent among urban, minority children in the US. Journal of Children and Media, 2(1), 19–36.

Bever, T. G., Smith, M. L., Bengen, B., & Johnson, T. G. (1975). Young viewers’ troubling response to TV ads. Harvard Business Review, 53, 109–120.

Blatt, J., Spencer, L., & Ward, S. (1972). A cognitive development study of children’s reactions to television advertising. In G. Comstock, J. Murry, & E. A. Rubinstein (Eds.), Television and social behavior (Vol. 4, pp. 452–467). Washington, DC: Government Printing Office.

Boush, D. M., Friestad, M., & Rose, G. M. (1994). Adolescent skepticism toward TV advertising and knowledge of advertiser tactics. Journal of Consumer Research, 21(1), 165–175.

Bramlett-Solomon, S., & Roeder, Y. (2008). Looking at race in children’s television. Journal of Children and Media, 2(1), 56–66.


Brand, J. E., & Greenberg, B. S. (1994). Commercials in the classroom: The impact of Channel One advertising. Journal of Advertising Research, 34(1), 18–27.

Brass, K. (1999, November 21). Pokemon fad at a fever pitch—and what a pitch indeed. Retrieved from 58047459/p1/article.html

Brucks, M., Armstrong, G. M., & Goldberg, M. (1988). Children’s use of cognitive defenses against television advertising: A cognitive response approach. Journal of Consumer Research, 14, 471–482.

Buckingham, D. (2011). The material child: Growing up in consumer culture. Cambridge, UK: Polity Press.

Bucy, E. P., Kim, S. C., & Park, M. C. (2011). Host selling in cyberspace: Product personalities and character advertising on popular children’s websites. New Media Society, 13(8), 1245–1264.

Buijzen, M. (2009). The effectiveness of parental communication in modifying the relation between food advertising and children’s consumption behaviour. British Journal of Developmental Psychology, 27, 105–121.

Buijzen, M., & Valkenburg, P. (2000). The impact of television advertising on children’s Christmas wishes. Journal of Broadcasting and Electronic Media, 44, 456–470.

Buijzen, M., & Valkenburg, P. M. (2002). Appeals in television advertising: A content analysis of commercials aimed at children and teenagers. Communications, 27, 349–364.

Buijzen, M., & Valkenburg, P. M. (2003a). The effects of television advertising on materialism, parent-child conflict, and unhappiness: A review of research. Applied Developmental Psychology, 24, 437–456.

Buijzen, M., & Valkenburg, P. M. (2003b). The unintended effects of television advertising. Communication Research, 30, 483–503.

Buijzen, M., & Valkenburg, P. M. (2005). Parental mediation of undesired advertising effects. Journal of Broadcasting and Electronic Media, 49, 153–165.

Buijzen, M., Van Reijmersdal, E. A., & Owen, L. H. (2010). Introducing the PCMC model: An investigative framework for young people’s processing of commercialized media content. Communication Theory, 20, 427–450.

Burr, P., & Burr, R. M. (1977). Product recognition and premium appeal. Journal of Communication, 27, 115–117.


Business Wire. (2011, September 7). Research and markets: Teen spending & behavior – 30 million U.S. teens aged 13–19 wielding more than $200 billion in buying power. Retrieved from Markets-Teen-Spending-Behavior—30

Butter, E. J., Popovich, P. M., Stackhouse, R. H., & Garner, R. K. (1981). Discrimination of television programs and commercials by preschool children. Journal of Advertising Research, 21(2), 53–56.

Cai, X., Gantz, W., Schwartz, N., & Wang, X. (2003). Children’s website adherence to the FTC’s online privacy protection rule. Journal of Applied Communication Research, 31, 346–362.

Cai, X., & Zhao, X. (2010). Click here, kids! Online advertising practices on popular children’s websites. Journal of Children and Media, 4(2), 135–154.

Calvert, S. L. (2008). The children’s television act. In S. L. Calvert & B. J. Wilson (Eds.), Blackwell handbook of child development and the media (pp. 455–478). New York, NY: Blackwell.

Carter, O. B. J., Patterson, L. J., Donovan, R. J., Ewing, M. T., & Roberts, C. M. (2011). Children’s understanding of the selling versus persuasive intent of junk food advertising: Implications for regulation. Social Science & Medicine, 72, 962–968.

Center for Science in the Public Interest. (1988, September 4). Kids are aware of booze as presidents, survey finds [Press release]. Washington, DC: Author.

Channel One News. (n.d.). Who are we? Retrieved from

Chia, S. C. (2010). How social influence mediates media effects on adolescents’ materialism. Communication Research, 37(3), 400–419.

Children Now. (2006). The future of children’s media: Advertising [Conference report]. Oakland, CA: Author.

Christenson, P. G. (1982). Children’s perceptions of TV commercials and products: The effects of PSA’s. Communication Research, 9, 491–524.

Churchill, G., Jr., & Moschis, G. P. (1979). Television and interpersonal influences on adolescent consumer learning. Journal of Consumer Research, 5(1), 23–35.

Cicchirillo, V., & Lin, J. (2011). Stop playing with your food: A comparison of for-profit and non-profit food-related advergames. Journal of Advertising Research, 51(3), 484-498.


Colby, P. A. (1993, April). From Hot Wheels to Teenage Mutant Ninja Turtles: The evolution of the definition of program length commercials on children’s television. Paper presented at the annual meeting of the Broadcast Education Association, Las Vegas, NV.

Condry, J. C., Bence, P. J., & Scheibe, C. L. (1988). Nonprogram content of children’s television. Journal of Broadcasting and Electronic Media, 32, 255–270.

Consumers Union Education Services. (1995). Captive kids: A report on commercial pressures on kids at school. Yonkers, NY: Author.

Creamer, M. (2005). Foul mouth: Stealth marketers flirt with law. Advertising Age, 76(40), 6.

Culley, J., Lazer, W., & Atkin, C. (1976). The experts look at children’s television. Journal of Broadcasting, 20, 3–20.

Culp, J., Bell, R. A., & Cassady, D. (2010). Characteristics of food industry web sites and “advergames” targeting children. Journal of Nutrition Education and Behavior, 42(3), 197–201.

Deatsch, K. (2008). EBay and Webkinz once again top most-searched terms. Retrieved from and-webkinz-once-again-top-most-searched-terms

DeDroog, S. M., Valkenburg, P. M., & Buijzen, M. (2011). Using brand characters to promote young children’s liking of and purchase requests for fruit. Journal of Health Communication, 16, 79–89.

Derbaix, C., & Bree, J. (1997). The impact of children’s affective reactions elicited by commercials on attitudes toward the advertisement and the brand. International Journal of Research in Marketing, 14, 207–229.

Derbaix, C., & Pecheux, C. (2003). A new scale to assess children’s attitude toward TV advertising. Journal of Advertising Research, 43, 390–399.

Dixon, H. G., Scully, M. L., Wakefield, M. A., White, V. M., & Crawford, D. A. (2007). The effects of television advertisements for junk food versus nutritious food on children’s food attitudes and preferences. Social Science and Medicine, 65, 1311–1323.

Donohue, T. R., Henke, L. L., & Donohue, W. A. (1980). Do kids know what TV commercials intend? Journal of Advertising Research, 20(5), 51–57.

Donohue, T. R., Henke, L. L., & Meyer, T. P. (1983). Learning about television commercials: The impact of instructional units on children’s perceptions of motive and intent. Journal of Broadcasting, 27, 251–261.

Dubow, J. S. (1995). Advertising recognition and recall by age—including


teens. Journal of Advertising Research, 35(5), 55–60. Dunnewind, S. (2004, November 20). Teen recruits create word-of-mouth

“buzz” to hook peers on products. Seattle Times. Retrieved from http://www.seattle

Enrico, D. (1999). Top 10 advertising icons. Advertising Age, 70(14), 42– 46.

Faber, R. J., Perloff, R. M., & Hawkins, R. P. (1982). Antecedents of children’s comprehension of television advertising. Journal of Broadcasting, 26, 575–584.

Fischer, P. M., Schwartz, M. P., Richards, J. W., Goldstein, A. O., & Rojas, T. H. (1991). Brand logo recognition by children aged 3 to 6 years: Mickey Mouse and Old Joe the Camel. Journal of the American Medical Association, 266, 3145–3148.

Folkvord, F., Anschutz, D. J., Buijzen, M., & Valkenburg, P. (2013). The effect of playing advergames that promote energy-dense snacks or fruit on actual food intake among children. The American Journal of Clinical Nutrition, 97, 239–245.

Fox, R. F. (1996). Harvesting minds: How TV commercials control kids. Westport, CT: Praeger/Greenwood.

Galst, J. P., & White, M. A. (1976). The unhealthy persuader: The reinforcing value of television and children’s purchase-influencing attempts at the supermarket. Child Development, 47, 1089–1096.

Gantz, W., Schwartz, N., Angelini, J. R., & Rideout, V. (2007). Food for thought: Television food advertising to children in the United States. Menlo Park, CA: Kaiser Family Foundation.

Goldberg, M. E. (1990). A quasi-experiment assessing the effectiveness of TV advertising directed to children. Journal of Marketing Research, 27, 445–454.

Goldberg, M. E., & Gorn, G. J. (1978). Some unintended consequences of TV advertising to children. Journal of Consumer Research, 5(1), 22–29.

Gorn, G. J., & Goldberg, M. E. (1977). The impact of television advertising on children from low income families. Journal of Consumer Research, 4(2), 86–88.

Gorn, G. J., & Goldberg, M. E. (1980). Children’s responses to repetitive television commercials. Journal of Consumer Research, 6, 421–424.

Graft, K. (2007, April 22). This week: The real Pokemon hits US. Retrieved from

Greenberg, B. S., & Brand, J. E. (1993). Television news and advertising in


schools: The “Channel One” controversy. Journal of Communication, 43, 143–151.

Greer, D., Potts, R., Wright, J. C., & Huston, A. C. (1982). The effects of television commercial form and commercial placement on children’s social behavior and attention. Child Development, 53, 611–619.

Harris, J. L., Speers, S. E., Schwartz, M. B., & Brownell, K. D. (2012). US food company branded advergames on the Internet: Children’s exposure and effects on snack consumption. Journal of Children and Media, 6, 51–68.

Harrison, K. (2006). Fast and sweet: Nutritional attributes to television food advertisements with and without Black characters. Howard Journal of Communication, 17, 249–264.

Harrison, K., & Bond, B. J. (2007). Gaming magazines and the drive for muscularity in preadolescent boys: A longitudinal examination. Body Image, 4, 269–277.

Harrison, K., & Hefner, V. (2006). Media exposure, current and future body ideals, and disordered eating among preadolescent girls: A longitudinal panel study. Journal of Youth and Adolescence, 35, 153–163.

Hawn, C. (2007, March 23). Time to play, money to spend. CNN Money. Retrieved from

Henry, H. K. M., & Borzekowski, D. L. G. (2011). The nag factor: A mixed- methodology study in the US of young children’s requests for advertised products. Journal of Children and Media, 5(3), 298–317.

Hof, M. (2012). Internet ad spending bucks economy to grow 12% in Q. Forbes. Retrieved from bucks-economy-to-grow-12-in-q1/

Howard, T. (2002, September 9). Real winner of “American Idol”: Coke. USA Today, p. 6B.

Hoy, M. G., Young, C. E., & Mowen, J. C. (1986). Animated host-selling advertisements: Their impacts on young children’s recognition, attitudes, and behavior. Journal of Public Policy and Marketing, 5, 171–184.

Huston, A. C., Greer, D., Wright, J. C., Welch, R., & Ross, R. (1984). Children’s comprehension of televised formal features with masculine and feminine connotations. Developmental Psychology, 20, 707–716.

Institute of Medicine. (2006). Food marketing to children and youth: Threat or opportunity? Washington, DC: National Academy of Sciences.

Jones, R. (2000). Kids are target of Pokemon’s shrewd marketing effort.


Retrieved from

Kahlenberg, S. G., & Hein, M. M. (2010). Progression on Nickelodeon? Gender-role stereotypes in toy commercials. Sex Roles, 62, 830–847.

Kaikati, A. M., & Kaikati, J. G. (2004). Stealth marketing: How to reach consumers surreptitiously. California Management Review, 98, 48–58.

Khermouch, G., & Green, J. (2001, July 30). Buzz marketing: Suddenly this stealth strategy is hot—but it’s still fraught with risk. BusinessWeek. Retrieved from

Kinsky, E. S., & Bichard, S. (2011). “Mom! I’ve seen that on a commercial!” US preschooler’s recognition of brand logos. Young Consumers, 12(2), 145–156.

Kline, S. (1993). Out of the garden: Toys, TV, and children’s culture in the age of marketing. New York, NY: Verso.

Krugman, D. M., Cameron, G. T., & White, C. M. (1995). Visual attention to programming and commercials: The use of in-home observations. Journal of Advertising, 24(1), 1–12.

Kunkel, D. (1988). Children and host-selling television commercials. Communication Research, 15, 71–92.

Kunkel, D. (2010). Mismeasurement of children’s understanding of the persuasive intent of advertising. Journal of Children and Media, 4(1), 109–117.

Kunkel, D., & Gantz, W. (1992). Children’s television advertising in the multichannel environment. Journal of Communication, 42(3), 134–152.

Kunkel, D., Wilcox, B. L., Cantor, J., Palmer, E., Linn, S., & Dowrick, P. (2004). Report of the APA Task Force on Advertising and Children. Washington, DC: American Psychological Association. Retrieved from

Lagorio, C. (2009, February 11). Resources: Marketing to kids. CBS News. Retrieved from 2798401.html

Larson, M. S. (2001). Interactions, activities and gender in children’s television commercials: A content analysis. Journal of Broadcasting and Electronic Media, 45, 41–56.

Lee, M., Choi, Y., Quilliam, E. T., & Cole, R. T. (2009). Playing with food: Content analysis of food advergames. The Journal of Consumer Affairs, 43(1), 129–154.

Levin, S. R., Petros, T. V., & Petrella, F. W. (1982). Preschoolers’


awareness of television advertising. Child Development, 53, 933–937. Levinson, J. C. (2007). Guerrilla marketing (4th ed.). New York, NY:

Houghton Mifflin. Lewin-Jones, J., & Mitra, B. (2009). Gender roles in television

commercials and primary school children in the UK. Journal of Children and Media, 3(1), 35–50.

Liebert, D. E., Sprafkin, J. N., Liebert, R. M., & Rubinstein, E. A. (1977). Effects of television commercial disclaimers on the product expectations of children. Journal of Communication, 27, 118–124.

Macklin, M. C. (1985). Do young children understand the selling intent of commercials? Journal of Consumer Affairs, 19, 293–304.

Macklin, M. C. (1987). Preschoolers’ understanding of the informational function of television advertising. Journal of Consumer Research, 14, 229–239.

Mangleburg, T. F., & Bristol, T. (1999). Socialization and adolescents’ skepticism toward advertising. In M. C. Macklin & L. Carlson (Eds.), Advertising to children: Concepts and controversies (pp. 27–48). Thousand Oaks, CA: Sage.

Martin, M. C. (1997). Children’s understanding of the intent of advertising: A meta-analysis. Journal of Public Policy and Marketing, 16, 205–216.

Martin, M. C., & Gentry, J. W. (1997). Stuck in the model trap: The effects of beautiful models in ads on female pre-adolescents and adolescents. Journal of Advertising, 26(2), 19–33.

Martin, M. C., & Kennedy, P. F. (1993). Advertising and social comparison: Consequences for female pre-adolescents and adolescents. Psychology and Marketing, 10, 513–530.

Mazur, L. A. (1996, May/June). Marketing madness. E Magazine: The Environmental Magazine, 7(3), 36–42.

McAllister, M. P. (2007). “Girls with a passion for fashion”: The Bratz brand as integrated spectacular consumption. Journal of Children and Media, 1, 244–258.

McNeal, J. U. (1998). Tapping the three kids’ markets. American Demographics, 20(4), 36–41.

McNeal, J. U. (1999). The kids’ market: Myths and realities. Ithaca, NY: Paramount Market.

McNeal, J. U. (2007). On becoming a consumer: Development of consumer behavior patterns in childhood. Burlington, MA: Butterworth- Heinemann.


Miller, J. H., & Busch, P. (1979). Host selling vs. premium TV commercials: An experimental evaluation of their influence on children. Journal of Marketing Research, 16, 323–332.

Minow, N. (2004, September 21). “Have you heard?” Stealth advertising puts products and pitches everywhere . . . and you may never know. Chicago Tribune. Retrieved from

Miyazaki, A. D., Stanaland, A. J. S., & Lwin, M. O. (2009). Self-regulatory safeguards and the online privacy of preteen children: Implications for the advertising industry. Journal of Advertising, 38(4), 79–91.

Molnar, A., Boninger, F., & Fogarty, J. (2011). The educational cost of schoolhouse commercialism—the fourteenth annual report on schoolhouse commercializing trends: 2010–2011. Boulder, CO: National Education Policy Center. Retrieved from

Montgomery, K. C., & Chester, J. (2009). Interactive food and beverage marketing: Targeting adolescents in the digital age. Journal of Adolescent Health, 45, S18–S29.

Moore, R. L., & Stephens, L. F. (1975). Some communication and demographic determinants of adolescent consumer learning. Journal of Communication, 29, 197–201.

Moore, E. S. (2006). It’s child’s play: Advergaming and the online marketing of food to children. Menlo Park, CA: Kaiser Family Foundation.

Morris, L. A., Mazis, M. B., & Brinberg, D. (1989). Risk disclosures in televised drug advertising to consumers. Journal of Public Policy and Marketing, 8, 64–80.

Moscardelli, D. M., & Divine, R. (2007). Adolescents’ concern for privacy when using the Internet: An empirical analysis of predictors and relationships with privacy-protecting behaviors. Family and Consumer Sciences Research Behavior, 35, 232–252.

Moschis, G. P. (1978). Teenagers’ responses to retailing stimuli. Journal of Retailing, 54, 80–93.

Moschis, G. P., & Churchill, G. A. (1978). Consumer socialization: A theoretical and empirical analysis. Journal of Marketing Research, 15, 599–609.

Moschis, G. P., & Moore, R. L. (1979). Decision making among the young: A socialization perspective. Journal of Consumer Research, 6, 101–112.

Moschis, G. P., & Moore, R. L. (1982). A longitudinal study of television


advertising effects. Journal of Consumer Research, 9, 279–286. Muehling, D. D., & Kolbe, R. H. (1999). A comparison of children’s and

prime-time fine-print advertising disclosure practices. In M. C. Macklin & L. Carlson (Eds.), Advertising to children: Concepts and controversies (pp. 143–164). Thousand Oaks, CA: Sage.

New American Dream. (2002). Thanks to ads, kids won’t take no, no, no, no, no, no, no, no, no for an answer. Retrieved from

Owen, L., Hang, H., Lewis, C., & Auty, S. (2012). Children’s processing of embedded brand messages: Product placement and the role of conceptual fluency. In L. J. J. Shrum (Ed.), The psychology of entertainment media (2nd ed., pp. 65–92). New York, NY: Routledge.

Palmer, E. L., & McDowell, C. N. (1979). Program/commercial separators in children’s television programming. Journal of Communication, 29, 197–201.

Palmer, E. L., & McDowell, C. N. (1981). Children’s understanding of nutritional information presented in breakfast cereal commercials. Journal of Broadcasting, 25, 295–301.

Palmerton, P. R., & Judas, J. (1994, July). Selling violence: Television commercials targeted to children. Paper presented at the annual meeting of the International Communication Association, Sydney, Australia.

Pecora, N. O. (1998). The business of children’s entertainment. New York, NY: Guilford.

Pereira, C. (2011). Pokemon Black & White day one sales exceed 1 million. Retrieved from white-day-one-sales-1-million

Peterson, L., & Lewis, K. E. (1988). Preventive intervention to improve children’s discriminating of the persuasive tactics in televised advertising. Journal of Pediatric Psychology, 3, 163–170.

Pine, K. J., & Nash, A. (2003). Barbie or Betty? Preschool children’s preference for branded products and evidence for gender-linked differences. Developmental and Behavioral Pediatrics, 24, 219–224.

Resnik, A., & Stern, B. L. (1977). Children’s television advertising and brand choice: A laboratory experiment. Journal of Advertising, 6(3), 11– 17.

Richards, J. I., Wartella, E. A., Morton, C., & Thompson, L. (1998). The growing commercialization of schools: Issues and practices. Annals of the American Academy of Political and Social Science, 557, 148–163.


Richins, M. L. (1991). Social comparison and the idealized images of advertising. Journal of Consumer Research, 18, 71–83.

Roberts, D. F. (1982). Children and commercials: Issues, evidence, interventions. Prevention in Human Services, 2(1/2), 19–35.

Roberts, D. F., Christenson, P., Gibson, W. A., Mooser, L., & Goldberg, M. E. (1980). Developing discriminating consumers. Journal of Communication, 30(3), 94–105.

Robertson, T. S., & Rossiter, J. R. (1974). Children and commercial persuasion: An attribution theory analysis. Journal of Consumer Research, 1, 13–20.

Robertson, T. S., & Rossiter, J. R. (1977). Children’s responsiveness to commercials. Journal of Communication, 27, 101–106.

Robertson, T. S., Ward, S., Gatignon, H., & Klees, D. M. (1989). Advertising and children: A cross-cultural study. Communication Research, 16, 459–485.

Robinson, T. N., Borzekowski, D. L., Matheson, D. M., & Kramer, H. C. (2007). Effects of fast food branding on young children’s taste preferences. Archives of Pediatrics and Adolescent Medicine, 161, 792– 797.

Robinson, T. N., Saphir, M. N., Kraemer, H. C., Varady, A., & Haydel, K. F. (2001). Effects of reducing television viewing on children’s requests for toys: A randomized controlled trial. Journal of Developmental and Behavioral Pediatrics, 22(3), 185–187.

Rosenberg, J. M. (1992, February 18). Toymaker upbeat about coming year. Santa Barbara News Press, p. C4.

Ross, R. P., Campbell, T. A., Wright, J. C., Huston, A. C., Rice, M. L., & Turk, P. (1984). When celebrities talk, children listen: An experimental analysis of children’s responses to TV ads with celebrity endorsement. Journal of Applied Developmental Psychology, 5(3), 185–202.

Rozendaal, E., Buijzen, M., & Valkenburg, P. (2009). Do children’s cognitive advertising defenses reduce their desire for advertised products? Communications, 34, 287–303.

Rozendaal, E., Buijzen, M., & Valkenburg, P. (2011). Children’s understanding of advertisers’ persuasive tactics. International Journal of Advertising, 30(2), 329–350.

Rozendaal, E., Buijzen, M., & Valkenburg, P. (2012). Think-aloud process superior to thought-listing in increasing children’s critical processing of advertising. Human Communication Research, 38, 199–221.


Rozendaal, E., LaPierre, M. A., van Reijmersdal, E. A., & Buijzen, M. (2011). Reconsidering advertising literacy as a defense against advertising effects. Media Psychology, 14(4), 333–354.

Schmitt, K. L., Woolf, K. D., & Anderson, D. K. (2003). Viewing the viewers: Viewing behaviors by children and adults during television programs and commercials. Journal of Communication, 53, 265–281.

Schor, J. B. (2004). Born to buy: The commercialized child and the new commercial culture. New York, NY: Scribner’s.

Shaker, E. (Ed.). (2000, July). In the corporate interest: The YNN experience in Canadian schools. Ottawa, Ontario: Canadian Centre for Policy Alternatives. Retrieved from

Sheikh, A. A., & Moleski, L. M. (1977). Conflict in the family over commercials. Journal of Communication, 27, 152–157.

Shin, A. (2007, April 8). TV shows targeting the diaper demographic. Washington Post. Retrieved from

Singer, N. (2012, August 22). Web sites accused of collecting data on children. New York Times. Retrieved from of-collecting-data-on-children.html?_r=0

Smith, S. L., & Atkin, C. (2003). Television advertising and children: Examining the intended and unintended effects. In E. L. Palmer & B. M. Young (Eds.), The faces of televisual media: Teaching, violence, selling to children (pp. 301–326). Mahwah, NJ: Lawrence Erlbaum.

Stern, B. L., & Resnik, A. J. (1978). Children’s understanding of a televised commercial disclaimer. In S. C. Jain (Ed.), Research frontiers in marketing: Dialogues and directions (pp. 332–336). Chicago, IL: American Marketing Association.

Stice, E., & Shaw, H. E. (1994). Adverse effects of the media portrayed thin-ideal on women and linkages to bulimic symptomatology. Journal of Social and Clinical Psychology, 13, 288–308.

Stoneman, Z., & Brody, G. H. (1981). The indirect impact of child-oriented advertisement on mother-child interactions. Journal of Applied Developmental Psychology, 2, 369–376.

Stutts, M. A., Vance, D., & Hudleson, S. (1981). Program-commercial separators in children’s television: Do they help a child tell the difference between Bugs Bunny and the Quik Rabbit? Journal of Advertising, 10(2), 16–25.


Tan, A. S. (1979). TV beauty ads and role expectations of adolescent female viewers. Journalism Quarterly, 56, 283–288.

Teenage Research Unlimited. (2004). Teens spent $175 billion in 2003. Retrieved from

Turow, J. (2001). Privacy policies on children’s websites: Do they play by the rule? Washington, DC: Annenberg Public Policy Center of the University of Pennsylvania.

Turow, J. (2003). Americans & online privacy: The system is broken. Washington, DC: Annenberg Public Policy Center of the University of Pennsylvania.

Turow, J., & Nir, L. (2000). The Internet and the family 2000: The view from parents; the view from kids. Washington, DC: Annenberg Public Policy Center of the University of Pennsylvania.

Valkenburg, P. M., & Buijzen, M. (2005). Identifying determinants of young children’s brand awareness: Television, parents and peers. Journal of Applied Developmental Psychology, 4, 456–468.

Valkenburg, P. M., & Cantor, J. (2001). The development of a child into a consumer. Journal of Applied Developmental Psychology, 22(1), 61–72.

Vega, V., & Roberts, D. F. (2011). Linkages between materialism and young people’s television and advertising exposure in a US sample. Journal of Children and Media, 5(2), 181–193.

Viral marketing agency releases tool to track online buzz. (2007, April 14). Retrieved from

Ward, S., Levinson, D., & Wackman, D. (1972). Children’s attention to advertising. In E. A. Rubinstein, G. A. Comstock, & J. P. Murray (Eds.), Television and social behavior (Vol. 4, pp. 491–515). Washington, DC: Government Printing Office.

Ward, S., & Wackman, D. (1972). Family and media influences on adolescent consumer learning. In E. A. Rubinstein, A. Comstock, & J. P. Murray (Eds.), Television and social behavior (Vol. 4, pp. 554–565). Washington, DC: Government Printing Office.

Ward, S., & Wackman, D. B. (1973). Children’s information processing of television advertising. In P. Clarke (Ed.), New models for mass communication research (pp. 119–146). Beverly Hills, CA: Sage.

Ward, S., Wackman, D. B., & Wartella, E. (1977). How children learn to buy: The development of consumer information-processing skills. Beverly Hills, CA: Sage.


Warren, R., Wicks, R. H., Wicks, J. L., Fosu, I., & Chung, D. (2008). Food and beverage advertising on US television: A comparison of child- targeted versus general audience commercials. Journal of Broadcasting and Electronic Media, 52(2), 231–246.

Wartella, E., & Ettema, J. S. (1974). A cognitive developmental study of children’s attention to television commercials. Communication Research, 1, 69–88.

Wartella, E., & Jennings, N. (2001). Hazards and possibilities of commercial TV in the schools. In D. G. Singer & J. L. Singer (Eds.), Handbook of children and the media (pp. 557–570). Thousand Oaks, CA: Sage.

Waters, H. F., & Uehling, M. D. (1985, May 13). Toying with kids’ TV. Newsweek, 105, 85.

Welch, R. L., Huston-Stein, A., Wright, J. C., & Plehal, R. (1979). Subtle sex-role cues in children’s commercials. Journal of Communication, 29, 202–209.

Wells, T. (2011). Chasing youth culture and getting it right. Hoboken, NJ: John Wiley.

Wicks, J. L., Warren, R., Fosu, I., & Wicks, R. H. (2009). Dual-modality disclaimers, emotional appeals, and production techniques in food advertising airing during programs rated for children. Journal of Advertising, 38(4), 93–105.

Wilcox, B. L., & Kunkel, D. (1996). Taking television seriously: Children and television policy. In E. F. Zigler & S. L. Kagan (Eds.), Children, families, and government: Preparing for the twenty-first century (pp. 333–352). New York, NY: Cambridge University Press.

Wilke, J., Therrien, L., Dunkin, A., & Vamos, M. N. (1985, March 25). Are the programs your kids watch simply commercials? BusinessWeek, p. 53.

Williams, L. A., & Burns, A. C. (2000). Exploring the dimensionality of children’s direct influence attempts. Advances in Consumer Research, 27, 64–71.

Wilson, B. J., & Weiss, A. J. (1992). Developmental differences in children’s reactions to a toy advertisement linked to a toy-based cartoon. Journal of Broadcasting and Electronic Media, 36, 371–394.

Wilson, B. J., & Weiss, A. J. (1995, May). Children’s reactions to a toy- based cartoon: Entertainment or commercial message? Paper presented to the International Communication Association, Albuquerque, NM.

Yang, M., Roskos-Ewoldsen, D. R., Dinu, L., & Arpan, L. M. (2006). The


effectiveness of “in-game” advertising comparing college students’ explicit and implicit memory for brand names. Journal of Advertising, 35, 143–152.

Zuckerman, P., Ziegler, M., & Stevenson, H. W. (1978). Children’s viewing of television and recognition memory of commercials. Child Development, 49, 96–104.




Educational and Prosocial Media

hildren spend more time engaged with media than they spend doing any other activity besides sleeping.1 Over the course of their childhood, they will also spend more time watching television than they will in the classroom (Hearold, 1986). We know from several chapters of this book that there are many potential negative effects

of watching television shows and movies, playing video and computer games, reading magazines, and surfing the Web. But is there anything positive that can come from the important and extensive role of media in children’s lives? Can media use be intellectually and cognitively beneficial? Can children’s exposure to enriching content enhance children’s social and emotional well-being?

In this chapter, we consider the economic and regulatory forces that shape the availability of positive media for children today. We examine different ways in which media have been found to be “educational” for children— specifically, the media’s contribution to academic knowledge, creativity, and language development. From there, we consider whether there are contextual or medium-related differences in how children learn from media and what they can learn. Finally, we examine the category of media and outcomes that are labeled “prosocial.” The focus of this chapter is on the benefits of television for children’s healthy development, in part because this tends to be the medium of choice for most children and in part because this is the most thoroughly studied medium. When possible, we also consider the growing body of research on newer media, including computer- based media and video games.

Economic and Regulatory Forces That Affect Media Offerings for Children



Most companies that make media, including prosocial and educational media for children, are part of mega-conglomerates that often own numerous media types (e.g., magazines, movie production houses, television networks, music recording studios, websites) and sometimes numerous nonmedia companies. As of this writing, the Walt Disney Company, for example, owns the Disney Channel, the ABC television network, Touchstone, Pixar Animation, and Marvel Worldwide. It also owns the Disney Interactive Media Group, Disney theme and water parks, and many kids’ TV properties, including Schoolhouse Rock ( The driving force behind all media companies is the economic bottom line and accountability to company shareholders. As such, the marketplace economy for children’s media does not always work in the best interests of the developing child (McIntyre, 2013). For this reason, the U.S. system of public broadcasting, like noncommercial television in countries around the world, carves out portions of its broadcast day to ensure that the needs children are met through prosocial and educational content.

Regulation Turow (1981) has observed that the early days of television saw plenty of

programs geared to children with the hope that child viewers would badger their parents into buying TV sets. Over the years, child-oriented programs were slowly replaced with programs for adults, in the expectation that adult audiences could lure in more advertising dollars. By the 1970s, the lack of quality and quantity in children’s programming led public and advocacy groups, such as Action for Children’s Television (ACT), to pressure the Federal Communications Commission (FCC)—the U.S. regulatory agency in charge of television broadcasters—to step in (Kunkel & Wilcox, 2001) (see Chapter 13). The FCC responded in 1974 by issuing guidelines calling for broadcasters to make a “meaningful effort” to provide a “reasonable amount” of educational programming for children (Kunkel & Canepa, 1994). Regulators hoped that broadcasters would improve the quantity and quality of children’s programming voluntarily, although the FCC warned broadcasters that if they did not do so, stricter rules would be forthcoming.

The result? By 1978, children’s programming had not improved. ACT petitioned the FCC to conduct an inquiry into compliance with the 1974 policy statement, and within the year, the FCC concluded that broadcasters had not met their obligations and recommended regulatory action. The commission proposed a minimum weekly requirement of children’s



programming (five hours of educational programming for preschoolers and two and a half hours of educational programming for school-aged children). It also proposed defining “educational” programs as those addressing “history, science, literature, the environment, drama, music, fine arts, human relations, other cultures and languages, and basic skills such as reading and mathematics” (FCC, 1979). The proposal languished.

Undeterred, advocates took up the cause with congressional leaders and ultimately gained passage of a piece of legislation known as the Children’s Television Act of 1990 (CTA). This bill emerged from Congress as an amendment to the Communications Act and implementation was left to the FCC, although the language was significantly modified (and watered down) from what advocates were pressing for (Kunkel, 1998). Essentially, the CTA mandated that broadcasters serve the “educational/informational needs of children through the licensee’s overall programming, including programming specifically designed to serve such needs” (CTA, 2006). Educational/informational programming was broadly defined as content that will “further the positive development of the child in any respect, including the child’s cognitive/intellectual or emotional/social needs” (CTA, 2006). Left undefined, however, were issues such as how much programming is enough, how age specific the programming needs to be, when the programming needs to air, and how the programming should be identified.

The Children’s Television Act of 1990 did not dramatically change the landscape of children’s television. As noted in Chapter 13, Kunkel and Canepa (1994) found inconsistencies in how licensees submitted their applications and dubious claims of educational value for programs such as Teenage Mutant Ninja Turtles and G. I. Joe. Lawmakers were ready to tighten the loopholes. By 1997, the FCC had adopted a processing guideline wherein broadcasters would be fined for making false claims about their educational efforts on behalf of children (FCC, 1996).2 In addition, the FCC processing guideline specified how much, when, and to whom such “core” educational programming must be directed to qualify for an expedited license renewal. (See Figure 3.1 for a summary of the “three-hour rule” guidelines for educational programming.)

Despite a government mandate to provide informational/educational material to children over the public airwaves, analyses show that in the U.S. there few high-quality educational programs on commercial broadcast stations (Wilson, Kunkel, & Drogos, 2008). Why are there not more high- quality programs available, and why are those that are available widely


seen as less profitable for the networks than the lower-quality programs? Clearly, these concerns go hand in hand. If broadcasters could make more money on the high-quality, educational programs, they would be more likely to air them.

Economics Television programs have traditionally received the bulk of their profits

from advertising revenue (Jordan, 2004). Historically, companies that advertised to children through the medium of television were most interested in reaching the largest possible number of children between the ages of 2 and 12. Competition for advertisers’ dollars in an ever more crowded field led broadcasters to keep a close eye on the ratings. If the programs don’t reach ratings expectations, networks must “make good” by providing free airtime elsewhere in their schedule (Jordan, 1996).

Prior to the proliferation of cable access, most broadcast networks aimed for the largest possible audience of 6- to 11-year-olds. The widespread adoption of cable and satellite television has created a “niche programming” model, where narrower slices of the audience allow for a more focused tailoring of advertising messages. One example of this is the Disney Channel’s discovery of the “tween” audience—children (primarily girls) who are not yet teenagers but are no longer interested in cartoons.

Figure 3.1 Core educational programming requirements.

SOURCE: Federal Communications Commission MM Docket No. 93-48.

Television shows, video games, websites, and other platforms have increasingly been merging into a form that Henry Jenkins describes as “transmedia storytelling” in his book Convergence Culture (2006, p. 20).



“Transmedia” can be thought of as a franchise property, title, or set of characters that “live” on multiple media platforms such as DVDs, television channels, video games, and websites. As Phillips (2012) writes, “the stories in these projects are interwoven, but lightly; each piece can be consumed on its own, and you’ll still come away with the idea that you were given a complete story” (p. 13). An example of franchise transmedia is the Disney property High School Musical (HSM), which is a collection of titles with a group of characters designed to appeal to tween girls. HSM began as a made-for-TV movie on the Disney Channel and quickly extended to music CDs, theatrical release films, a Wii dance game and a Nintendo handheld video game, and a book series featuring East High (see Figure 3.2.). A more complex way of thinking about transmedia, however, focuses less on the windowing of a property and more on the narrative experience of the user. In Jenkins’s definition, transmedia storytelling

represents a process where integral elements of a fiction get dispersed systematically across multiple delivery channels for the purpose of creating a unified and coordinated entertainment experience. Ideally, each medium makes its own unique contribution to the unfolding of the story. (quoted in Phillips, 2012, p. 15)

Examples of this way of thinking about transmedia include the Star Wars media property, the Harry Potter phenomenon, and the Batman franchise. From this perspective, an economically successful children’s media property will be one that “has legs”; in other words, it has the potential for longevity and it provides opportunities to extend the story and the audience’s experience of it into multiple media and nonmedia domains.

Figure 3.2 Disney’s transmedia property High School Musical.



SOURCE: Disney Channel (left); Nintendo Wii game (right).

Children’s media properties can also make money through international distribution channels (Jordan, 2004; Pecora, 1998). A property that is appealing to an international audience, for example, can not only sell advertising on the television program but also extend the profits to be made from licensing fees. Sesame Workshop, a nonprofit production company based in New York, has agreed to license the use of its name and its characters to a for-profit educational company that offers preschool education in India. Galli Galli Sim Sim, the Hindi version of Sesame Street, has been popular in this country and its characters are well-known to Indian schoolchildren and their parents. For the right to use the brand and materials, franchisees will pay Sesame Workshop a fee and a cut of tuition revenue (Garrison, 2012).

The opportunities presented by cultivating international audiences come with challenges too. Though animated cartoons with a lot of action sequences can be dubbed easily and have storylines that are universally understandable, narrowly tailored and culturally specific educational or prosocial content may be less appealing to worldwide audiences. The Warner Bros. program Histeria!, which focused on teaching history lessons through humor and animation, used contained content (e.g., details about the American Revolutionary War) that would not be of much interest abroad. The program lasted only a few seasons.



Children’s Educational Learning From Media Most programs that air on broadcast stations to fulfill FCC requirements are what we might consider “prosocial”—programs that address children’s ability to feel good about themselves and get along well with others (Jordan, 2004; Wilson et al., 2008). Such content is important, and will be addressed later in the chapter. In this section, however, we explore the relationship between children’s media use and their cognitive, intellectual, and academic skills. Though many have argued that entertainment media use is antithetical to learning (because it displaces time spent in more intellectually stimulating activities; see Healy, 1990), many have also linked children’s media use to creativity, language development, school-related learning, and more (D.R. Anderson, Huston, Schmitt, Linebarger, & Wright, 2001). Research reveals that it is critical to consider not whether or how much television children are exposed to in the early years, but rather what kind of television is on in the household. Barr and her colleagues (2010) followed 60 children between the ages of 1 and 4 and found that high levels of exposure to television programs designed for adults during the preschool years were associated with poorer executive functioning skills, such as attention and working memory, and other cognitive outcomes at age 4 (see Chapter 1 for a lengthier discussion of executive functioning). Of note, however, there was no relationship between exposure to child-oriented television and these outcomes. As discussed in Chapter 11, parents may be less likely to interact with their children when the television is constantly on (Christakis et al., 2001; Kirkorian, Pempek, Murphy, Schmidt, & Anderson, 2009), and children’s play may be disrupted by the constant barrage of noises from adult TV that they don’t understand (Schmidt, Pempek, Kirkorian, Lund, & Anderson, 2008).

The Lessons of Sesame Street and Children’s Educational Media

Far and away, the majority of studies on preschool children’s learning from television have involved Sesame Street (Fisch, Truglio, & Cole, 1999) (see Figure 3.3). The program, launched in 1969, was designed by producer and founder Joan Ganz Cooney to address the gap between children who had access to preschool and other economic advantages and those who did not (Fisch & Truglio, 2001). In Cooney’s words, “it’s not whether children learn from television, it’s what they learn” (Knowlton & Costigan, 2006).



From the beginning, a research team was in place to ensure that children not only liked the characters and the programs but also learned from them. The data suggest that the program did—and still does—achieve its mission of making children more “ready to learn” (Fisch & Bernstein, 2001).

Figure 3.3 PBS’s Sesame Street.

SOURCE: © Sesame Workshop.

Through his research on Sesame Street and other programs such as Gullah Gullah Island and Blue’s Clues, Daniel Anderson has provided convincing evidence that children are active and engaged viewers. In one clever study, Anderson and his colleagues replaced the Sesame Street soundtrack with Greek (D.R. Anderson, Lorch, Field, & Sanders, 1981). They found that children paid less attention when they could not understand what they were watching. In another, Anderson mixed up the narratives so that the bits did not make sense. Again, children paid less attention (D.R. Anderson et al., 1981). Anderson argues that children bring their learning skills to bear when they watch television, and if they determine that a program is nonsensical, they stop attending. This is a far different argument from that of social critics who have asserted that television’s fast cuts and funny voices are solely responsible for driving children’s attention (Healy,



1990). Children want to understand television, and if they do not, they stop watching.

Sesame Street research has also indicated that children learn most when a parent is involved in the viewing. In fact, even if a mother is simply in the room coviewing and not saying anything, children learn more than if she is not present (although they learn most when the mother is actively engaged, talking and pointing things out) (Wright, St. Peters, & Huston, 1990). For this reason, the creators of Sesame Street intentionally inserted content that only adults would understand or find funny, such as the takeoff on the opera singer Placido Domingo (on the show he is Placido Flamingo) or the inclusion of adult celebrities (such movie stars as Glenn Close or the rock band R.E.M.). Despite this, parents’ coviewing of Sesame Street has declined significantly over the years, to the point where producers determined that the adult-oriented portions of the program were providing few benefits to the majority of the viewing audience. Most of the adult- oriented content has therefore been stripped from the program (Fisch & Truglio, 2001).

Research on preschoolers’ viewing of educational programming beyond Sesame Street also suggests learning benefits. Studies have shown that multiple viewings of the program Blue’s Clues, in which a host encourages child viewers to help solve puzzles posed by his sidekick dog Blue, lead to a greater increase in engagement with the program, an increase in specific attention skills, and more use of problem solving strategies when compared to a single viewing (Crawley, Anderson, Wilder, Williams, & Santomero, 1999) or the viewing of a noninteractive children’s educational program (Crawley et al., 2002) (see Figure 3.4).

Media and Make-Believe Television and other entertainment media use—such as video game

playing—is sometimes blamed for stifling children’s creativity, imagination, and make-believe (or pretend) play. Because these are cognitive activities that are linked to language development, critical thinking, and abstract thinking, such an accusation should be taken seriously (Bellin & Singer, 2006). Certainly, children’s imaginative play is influenced by their environment, including the presence or absence of electronic media, as well as their developmental stages. Valkenburg (2001) suggests that there are contradictory opinions about the influence of media, in particular television, on play and creativity. One line of thinking, which Valkenburg labels the



“stimulation hypothesis,” suggests that media enrich the store of ideas from which children can draw when engaged in imaginative play or creative tasks (p. 123). TV content may be incorporated into pretend play, computer game settings may spark curiosity about other people and places, and music may set off images and emotions that might otherwise lie dormant. At least two preschool educational programs have been linked with increased imaginative play and creative thinking: Mister Rogers’ Neighborhood (which includes a clear transition from the real-world setting for Fred Rogers’s home to the Land of Make-Believe via trolley) (D.R. Anderson et al., 2001; Singer & Singer, 1976) and Barney & Friends (which has imagination—led by a big purple dinosaur—as a central tenet of the core curriculum) (Singer & Singer, 1998) (see Figure 3.5). Research on the viewing of these programs shows significant gains in creative and imaginative play when compared with the viewing of other children’s programs (Singer & Singer, 1976). Importantly, however, gains are greatest when viewing is facilitated by adults, either parents or teachers (Hogan, 2012a).

Figure 3.4 Nickelodeon’s Blue’s Clues.

SOURCE: ©2008 Nickelodeon UK Limited. All rights reserved.



An alternative hypothesis, which Valkenburg (2001) calls the “reduction hypothesis,” suggests that media stifle children’s creative capacities by replacing more cognitively stimulating activities (such as reading or playing with friends) with passive viewing and mindless surfing. In addition, some media (particularly those that have both audio and visual components) might be seen as supplanting children’s imaginings with prefabricated pictures from which children have trouble disassociating (Runco & Pezdek, 1984; Valkenburg & Beentjes, 1997). Researchers looking specifically at the content of media have also argued that media violence adversely affects imaginative play, although it is not clear whether this is because children become more impulsive (Singer, Singer, & Rapaczynski, 1984) or more anxious (Fein, 1981), or whether some other mechanism is at work.

Figure 3.5 PBS’s Barney & Friends.

SOURCE: ©PBS 2002–2008. All rights reserved.

Although there is little evidence that screen media use stimulates children’s imaginative play and creativity (with the exception of a few preschool programs), there is some suggestion that audiovisual media interventions can be designed to encourage play. My Magic Story Car, a video-based series designed to enhance children’s play with the goal of



building their early literacy skills, found quite positive effects when used in a classroom setting (Bellin & Singer, 2006). In this series, low-income, at- risk children and their caregivers are given explicit ideas for engaging in make-believe play. For example, adults help children assemble their own “magic story cars” (chairs, cushions, or cardboard boxes decorated with alphabet letters) with a “license plate” on which children are assisted in writing their names or initials. Child viewers drive their magic story cars to play learning games with make-believe narratives designed to strengthen specific emergent literacy skills, such as conceptions about print, and socioemotional skills, such as cooperative play. Bellin and Singer found that, when compared to a control group, children who were exposed to the intervention showed significant gains in virtually all aspects of emergent literacy. The brilliance of this program is in the recognition that parents and caregivers have, in many ways, forgotten how to “play” in ways that are developmentally constructive. In addition, My Magic Story Car capitalizes on the ubiquity of the medium and children’s affinity for it. Although similar claims have been made about the potential for video and computer games to stimulate creativity and imagination (Johnson, 2005; McGonigal, 2011), and although many of the games themselves claim to boost children’s make- believe skills (Valkenburg, 2001), research in this area is lacking.

Media and Language Learning Several studies have argued that DVDs with titles like Baby Einstein

mislead parents into thinking they will be educational for their infants. Research suggests that claims of the educational efficacy of such products are baseless. Separate studies by DeLoache and her colleagues (2010) and Krcmar (2011) found that children who watched a DVD designed for infants “12 months and up” learned virtually no words featured in the video. However, at least one study found evidence for a possible role of age- appropriate media in encouraging verbal interactions, particularly for infants living in low-income, immigrant families (Mendolsohn et al., 2010). In this longitudinal study, children whose parents coviewed educational television programs with them and interacted with them around the program content showed gains in language development at 14 months (Mendolsohn et al., 2010).

Media may contribute to children’s academic achievement by acting as an “incidental language teacher” (Naigles & Mayeux, 2001). In the course of a study of families’ use of television, researchers at the Annenberg Public



Policy Center employed the Peabody Picture Vocabulary Test (PPVT) to assess vocabulary (Scantlin & Jordan, 2006). One 9-year-old boy was given the word cascade and asked to point to the picture that represented the word. The boy immediately did so correctly, asserting that he had learned the word from his favorite video game! Indeed, for decades, researchers (Rice, 1984, 1990) have asserted that television programs have the potential to encourage children to understand and use new words, although it is unclear whether media can effectively teach more complex language acquisition skills such as grammar (Naigles & Mayeux, 2001).

Program complexity and age appropriateness of the verbal content of media both play an important role in language development. Linebarger and Walker (2004) examined the relationship between children’s television viewing and their expressive language and vocabulary. Unlike most studies, which look cross-sectionally at children’s cognitive abilities and their viewing patterns (making it difficult to establish causality), this study collected data on children’s viewing every three months, beginning at 6 months of age and ending at about 30 months of age. Even when parent’s education, child’s home environment, and child’s cognitive performance were statistically controlled, watching Dora the Explorer, Blue’s Clues, Arthur, Clifford the Big Red Dog, or Dragon Tales resulted in a larger vocabulary and higher expressive language scores (see Figure 3.6); watching Teletubbies was related to a smaller vocabulary and lower expressive language scores; watching Sesame Street was related only to lower expressive language scores; and watching Barney was related to a smaller vocabulary and more expressive language. What is interesting about this study is the notion that the type of educational program children watched resulted in different cognitive outcomes. Blue’s Clues and Dora are “interactive” shows, where children are encouraged to talk to the screen. Sesame Street is not (potentially explaining why there was less gain in expressive language). Barney aims to engage children in creative and imaginative play but keeps its language fairly simple and straightforward (potentially explaining the gap in vocabulary building).

Lasting Effects of Exposure to Educational Media In a 10-year longitudinal study that followed children from preschool to

high school, researchers in Massachusetts and Kansas found that children who watch educational television in the early years perform better some 10 years later, even when other important variables (such as family



socioeconomic and the availability of books) are factored in (D.R. Anderson et al., 2001). The researchers found that viewing educational versus entertainment programs was associated with greater gains, but some programs encouraged the development of skills more than others did. A similar study, which tracked two cohorts of German children over a four- year period, also found that although educational program viewing was positively correlated with reading achievement, relationships between entertainment program viewing and reading performance were negative (Ennemoser & Schneider, 2007). These important and groundbreaking studies ultimately concluded that McLuhan (1964) was wrong when he wrote, “The medium is the message.” Rather, they argue, “the message is the message” (D.R. Anderson et al., 2001, p. 134).

Figure 3.6 Nickelodeon’s Dora the Explorer and PBS’s Clifford the Big Red Dog.

SOURCE: First photo: ©2008 Viacom International Inc. All rights reserved. Second photo: ©2005 Scholastic Entertainment Inc. All rights reserved.

When the Medium Is the Message Despite what Daniel Anderson and his colleagues (2001) argue,

however, there are properties of media that seem to encourage the use of some cognitive skills and academic pursuits. Studies of computer and video games suggest that visual attention, peripheral vision, and spatial reasoning can be improved by game play (see, e.g., McGonigal, 2011; Okagaki & Frensch, 1994; Subrahmanyam & Greenfield, 1994). Jackson and her colleagues (2006) found that children who were struggling as readers were helped by at-home use of the Internet (presumably because it encouraged the use of text-based information). Literacy has also been improved for at-risk



children when television captions have been made available onscreen, helping children to recognize and read more words, identify the meanings of those words, generate inferences regarding program content, and transfer those skills to other settings (Linebarger, Piotrowski, & Greenwood, 2010). Beal and Arroyo (2002) provided evidence that a user-driven computer game can effectively encourage the integration of math and science concepts above and beyond what a teacher alone can do within a classroom.

Figure 3.7

SOURCE: ©The New Yorker Collection 1991, Michael Crawford, from All rights reserved.

Children’s Social Learning From Media Though the term prosocial is often bandied about by the media industry, federal regulators, academics, and advocates, there is not necessarily a shared definition within or among these groups. Most writers suggest that prosocial media content is somehow socially helpful (such as that which promotes altruism, friendliness, acceptance of diversity, and cooperation). Others would include content that is more personally helpful (calming fears, engaging in safer sex practices, eating healthfully). In this chapter, we use the definition provided in one of the first comprehensive reports of the positive effects of the media, written in the 1970s, titled “Television and Behavior.” The authors define prosocial as that which is “socially desirable and which in some way benefits other persons or society at large” (quoted in Lowery & DeFleur, 1995, p. 354).



Any definition of prosocial involves some level of value judgment. Some might argue that a program that emphasizes “looking out for #1” prepares a child better for a competitive world than one that instills values of “cooperation.” Despite this caveat, we examine studies that have explored the benefits of prosocial media using the definition cited above: content which in some way benefits other persons or society at large. Most of the landmark studies were conducted in the 1970s, in response to increased federal funding to investigate the positive role of television in children’s lives (this came on the heels of the surgeon general’s report outlining the negative role of television—particularly the deleterious consequences of TV violence) (Lowery & DeFleur, 1995). The studies reviewed in this chapter are mainly focused on television content, though by extension, many of the findings would hold true for DVD and videotape viewing of the programs. Less clear is the impact of other electronic media—including computer and video games, Internet social websites (including networking sites), music, and magazines.

Many studies have found that children’s emotional and social skills are linked to their early academic standing (e.g., Wentzel & Asher, 1995). Children who have difficulty paying attention in class, getting along with their peers, and controlling their own negative emotions of anger and distress do less well in school (Arnold et al., 1999; McLelland, Morrison, & Holmes, 2000). What is more, longitudinal studies suggest that this link may be causal: “For many children, academic achievement in their first few years of schooling appears to be built on a firm foundation of children’s emotional and social skills” (Raver, 2002, p. 3). Specifically, research on early schooling suggests that the relationships that children build with peers and teachers are (a) based on children’s ability to regulate emotions in prosocial versus antisocial ways, and (b) a “source of provisions” that either help or hurt children’s chances of doing well, academically, in school (Ladd, Birch, & Buhs, 1999, p. 1375).

Developmental psychologists believe that children have a set of “emotional competencies” that determine how they think about and handle their own and others’ emotions (Saarni, 1990). For example, a child’s ability to recognize and label different emotions gives him or her powerful social tools. Children’s emotional styles are thought to be influenced not only by their temperament but also by their environments. Certainly, the ways in which parents use warmth, control, and harshness in the home matter (see Chapter 11). Media may matter too. As we shall see in a moment, media have been shown to be effective at developing skills such as



altruism and cooperation in young viewers.

Prosocial Media Content for Children In the early days of television, the networks featured many “family-friendly” prosocial programs such as Lassie, Captain Kangaroo, and The Waltons. Through the 1970s and early 1980s, content analyses revealed that children’s favorite programs often featured portrayals of empathy, altruism, and an exploration of feelings (Palmer, 1988). Networks soon discovered, however, that more money could be made on so-called program-length commercials—cartoons that were mainly vehicles for selling toys such as action figures (Kunkel, 1998). As a consequence, prosocial television declined through the 1980s and mid-1990s (Calvert & Kotler, 2003). The Children’s Television Act of 1990 aimed to reverse that trend, but it really was not until the FCC processing guideline went into effect—explicitly stating a minimum requirement of three hours per week of educational television—that the landscape of children’s television began to include more prosocial television. Despite this legislation, there is conflicting evidence about the extent to which prosocial content is available. One analysis of the top 20 shows for children and teens ages 2 to 17 found that only two contained themes of altruism, antiviolence, or friendliness in the episodes analyzed (Mares & Woodard, 2005). However, a broader analysis of 2,227 programs on 18 different channels found that 73% of the programs featured altruistic acts, with a rate of 2.92 incidents per hour (Smith et al., 2006). As described below, many studies find positive effects of prosocial content on children’s beliefs and behaviors. However, a meta-analysis of 35 prosocial studies found that the impact of prosocial television content seems to peak at age 7 and fall off rapidly after that (Mares & Woodard, 2005, 2012). For this reason, we look separately at content aimed at children versus that aimed at adolescents.

Do Prosocial Media Affect Youth? Researchers who study children’s prosocial learning from media

typically work under the assumption that characters who behave kindly, cooperatively, responsibly, and altruistically are providing models that children can learn from and subsequently imitate. Much of this research is grounded in Bandura’s social cognitive theory, which originally explored



how televised aggression might be imitated under certain conditions (see Chapter 4), but it has also looked at prosocial behavior that might result from media exposure. Generally speaking, the mechanism goes like this: Children observe a character behave in a positive manner. That behavior is more likely to be imitated if the character (a) is perceived as realistic, (b) is similar to the child (for example, in age or gender), (c) receives positive reinforcement, and (d) carries out an action that is imitable by the child (Thomas, 2005). Other theorists have argued that as children develop moral reasoning, they become better able to understand the motives of characters, judge the value of their actions, and assess the relevance of what they see, hear, and read for their own contexts and interpersonal relationships (Glover, Garmon, & Hull, 2011).

Prosocial content may also be providing children with skills for dealing with their emotions and managing their moods. As noted in Chapter 1, children are born with temperament but look to their environments to learn emotional competencies—for example, ways to feel better about themselves or get through a bad day. Sesame Street, in its four decades on the air, has taught children about emotional coping as one of its curricular goals. It has addressed the scariness of hurricanes, the jealousy that arrives with a new sibling, and even the uncertainty that came after the 2001 terrorist attacks. However, we know very little about the efficacy of these storylines. Similarly, Mister Rogers’ Neighborhood produced many episodes for children on topics that scared them or made them uncomfortable. (Indeed, there is a large body of research on children’s management of their fright reactions to media. See, for example, Cantor, 2012.)

Another potential mechanism underlying the relationship between media content and prosocial behavior may be that prosocial content offers children “scripts” for dealing with unfamiliar situations. According to schema or script theory, a schema is an organized structure of knowledge about a topic or event that is stored in memory and helps a person assimilate new information (Mandler, 1984). Schema theory suggests that people possess schemas for emotions, which include information about facial expressions, the cause of feelings, and the appropriate ways of expressing feelings. Children use schemas to help them interpret what they encounter in the media. In turn, media content can contribute to a child’s schemas. Cultivation theory, described in Chapter 5, has found that, over time, heavy TV viewers tend to adopt beliefs about the world that are consistent with television’s portrayal of the world. In other words, children who watch a lot of TV featuring crime or hospitals may come to see the world as a mean and



scary place (Gerbner, Gross, Signorielli, & Morgan, 1986). Mares, Braun, and Hernandez (2012) have found that media are particularly powerful for adolescents who have little exposure to the contexts they will eventually encounter. In one study, 5th graders were randomly assigned to watch a tween television episode that was high or low in social conflict and then asked questions about their future middle school, as well as about their typical TV diet. They found that children who were heavy viewers of tween-oriented television—which is rife with stereotypical cliques and interpersonal hostility—expected less friendliness and more bullying and had greater anxiety about attending their future school than did light viewers of such fare. The researchers also found that children who did not typically view this content but who saw the high-conflict episode in the experimental setting had lower expectations of friendliness and heightened expectations of hostility compared to those who saw the low-conflict episode.

The Research Evidence Empathy Social learning theory, cultivation theory, and schema theory might all be

used to understand children’s development of empathy, or the ability of children to understand and relate to another’s feelings by taking his or her perspective. Many would argue that the ability of humans to empathize with others is both hardwired and learned. Developmental psychologists who follow the Piagetian tradition would argue that it is not until children are 6 or 7 years old that they are “sociocentric” enough to understand that not everyone sees the world or events as they do. In one famous experiment, children were put in front of a constructed three-dimensional mountain with different objects placed on it. Piaget asked the child to choose, from four pictures, which view the experimenter would see (the experimenter was standing on the opposite side of the mountain). Younger children selected the picture of the view that they themselves saw (Thomas, 2005). From this experiment and others, Piaget argued that children have difficulty understanding others’ perspectives, including how they might feel. By the time children reach school age, they have become more attuned to the feelings and needs of others.

Research suggests that child audiences can recognize the feelings of media characters, though it appears that younger children are less likely to experience the character’s feelings (that is, empathize with them) than older children are. In one study, 3- to 5-year-olds and 9- to 11-year-olds watched



a scary movie clip. For one clip, a threatening “stimulus” was shown. For the other, a character’s fear in response to the threatening stimulus was shown. Older children were more frightened and physiologically aroused by the character’s fear than the younger children were, although all children recognized the character as frightened (Wilson & Cantor, 1985).

Calvert and Kotler (2003) examined prosocial programs for elementary school–aged youth airing on commercial broadcast, cable, and public television. Their two-pronged study involved 2nd to 6th graders in both a naturalistic reporting methodology (in which children logged onto a website and reported on what they were watching and what they learned) and an experimental methodology (in which children were shown programs in the classroom and asked about them afterward). Their research suggests that school-aged children learn from prosocial programs even more than from traditional, school-related educational shows. Moreover, much of what the children seemed to be learning was how to identify the emotions of characters and apply what they learned to their own lives. As one 6th-grade girl in the experimental condition wrote about the program Anatole,

This program was about a little mouse that tried her hardest in singing but just couldn’t do it. The mouse gave up and ripped her opera notes up because of her frustration. When her dad (Papa) met an Opera singer named Renee, he knew that if his daughter heard her singing, she would have kept her confidence. And she did. She learned that just because you are not good at something doesn’t mean you have to give up. And that is the lesson that I will keep in mind when I get frustrated with something I am not good at. (quoted in Calvert & Kotler, 2003, p. 316)

Altruism/Helping One of the first studies of the impact of prosocial television came with

the program Lassie, which ran from 1954 to 1974 on commercial broadcast TV. The show featured an extraordinary collie, who was devoted to her family and, in particular, her boy owner (Jeff). Because of her devotion and intelligence, Lassie often helped the family out of dangerous situations. In the experiment (Sprafkin, Liebert, & Poulos, 1975), 1st-grade children saw one of three TV shows. In one condition, they saw a prosocial episode of Lassie in which Jeff rescues a puppy. In the second, they viewed a “neutral” episode of Jeff trying to avoid taking violin lessons. In the third, the children watched a “competitive” episode of the Brady Bunch. After viewing the television program, children were told to play a game to win points and prizes. They were also told that if they needed assistance, they could press a



“help” button, though that would mean they would need to stop playing the game and presumably would be less likely to win a prize. Children could hear dogs barking with increasing intensity and distress through the experimental period (the barking was, of course, prerecorded). Children who saw the prosocial episode of Lassie were nearly twice as likely to seek help as children in the neutral condition. Children in the competitive condition were the least likely to seek help.

Jane McGonigal, author of the book Reality is Broken: Why Games Make Us Better and How They Can Change the World, has argued that young people who play video and computer games are given opportunities to work collectively and altruistically in the games they play. She cites the example of, an online game used by teachers to help children learn vocabulary and spelling and which donates rice through the World Food Programme to help end hunger ( As of August, 2012, over 96 billion grains of rice had been donated. Even with competitive games, there is an expectation of cooperation and collaboration. McGonigal writes,

Good games don’t just happen. Gamers work to make them happen. Any time you play a game with someone else, unless you’re just trying to spoil the experience, you are actively engaged in highly coordinated, prosocial behavior. No one forces gamers to play by the rules, to concentrate deeply, to try their best, to stay in the game, or to act as if they care about the outcome. They do it voluntarily, for the mutual benefit of everyone playing, because it makes a better game. (p. 269)

Social Interaction In a 1979 study, Friedrich-Cofer, Huston-Stein, Kipnis, Susman, and

Clewett explored the effects of daily exposure to Mister Rogers’ Neighborhood (see Figure 3.8), over a two-month period, on preschool children’s social interactions with one another. All of the children were enrolled in Head Start programs. In one classroom, children watched Mister Rogers, and teachers were trained and relevant play material was provided. In a second classroom, children watched Mister Rogers, but teachers had no training. However, relevant play material was provided. In the third, children viewed Mister Rogers, but there was neither teacher training nor program-related play material provided. In the final condition, children watched “neutral” films in classrooms containing irrelevant play material. Researchers observed children’s natural social behaviors in the



classroom and on the playground before and after the two months of viewing. They found that positive interactions with peers increased the most in the condition where children had exposure to prosocial programming, teachers were trained, and relevant play material was provided. Prosocial television alone, however, led to few differences in children’s behavior, at least in this early study.

Figure 3.8 PBS’s Mister Rogers’ Neighborhood.

SOURCE: ©2001 Family Communications, Inc., and PBS.

A second program that has been extensively studied is Barney & Friends. This program, which features a big purple dinosaur and emphasizes kindness and good manners, has been found to have a positive effect on children from diverse regions in the United States (Singer & Singer, 1998). Similar to the Mister Rogers study described above, day care centers were assigned to a viewing or a viewing-plus-lessons condition or a no-viewing control group. Even without the accompanying lessons, children who viewed Barney were rated as more civil and having better manners.

Acceptance of Others/Acceptance of Diversity



A major goal of the program Sesame Street has been to highlight the diversity of American life and to model racial harmony. Program characters include African Americans, Latino Americans, White Americans, American Indians, and Asian Americans. Even its Muppets are different colors! In 1989, in response to increasing racial unrest in the U.S., the producers and researchers at Sesame Workshop (the nonprofit production company that makes the program) designed a curriculum to encourage friendship among people of different races and cultures. Preschool viewers were encouraged to perceive people who look different from themselves as possible friends and to bring a child who had been rejected because of physical or cultural differences into the group. Truglio, Lovelace, Segui, and Schneider (2001) write that initially, there was some doubt as to whether race relations was truly an issue for preschoolers. However, a review of the literature, along with meetings with experts, revealed that preschoolers were aware of racial differences. Truglio and her colleagues’ formative research suggested that ethnic minority children felt less good about themselves and that White children were more likely to segregate African American children in an imaginary neighborhood they were asked to create. However, most of the children were open to the idea of being friends with children of different races.

One very interesting study analyzed two segments of Sesame Street that were created to address racial harmony and interaction. In one, “Visiting Ieshia,” a White girl visits an African American girl in her home. The other, “Play Date,” shows a similar visit that a White boy makes to his African American friend’s home. Researchers at Sesame Workshop found that children liked the segments and identified with and remembered them. Most of the children who viewed the episodes stated that the White girl felt positive about being at Ieshia’s home (70%) and the White boy felt positive about being at Jamal’s home (58%). However, less than half of the children who viewed “Play Date” felt that the African American mother in the program (48%) and the White mother of the visiting boy (39%) felt happy about the visit. Why? Preschoolers perceived their own mothers as not feeling positive about other-race friendships, even after viewing friendly and inviting images of parents in “Play Date.” From these findings, the researchers recommended that in future segments, mothers and fathers have a more prominent role in expressing support about the child character’s friendships with children of different races before, during, and after the visits. They also suggested that the segments show the parents of the different-race children interacting and expressing the positive value of


making good friends (Truglio et al., 2001).

The Limitations of Research on Prosocial Content for Children

It is unfortunate that so few studies have investigated the potential benefits of prosocial programming for children, particularly when there are so many programs now being offered by commercial broadcasters to satisfy the three-hour rule. As Mares and Woodard (2012) point out, there are still many unanswered questions about how best to design prosocial content for children. First, does children’s exposure to a specific prosocial portrayal (such as a character donating money) translate into more “general kindness” or “goodness”? They argue that such a link has been found in exposure to antisocial models (with, of course, the opposite effect), and that despite the fact that the research could be carried out fairly easily, it never has. The popular series American Idol, for example, televised a double episode called “Idol Gives Back” in which the judges spotlighted the ravages of poverty, including the desperate plight of AIDS-afflicted mothers and children in Africa. By modeling charitable behavior (one of the episode’s hosts, Ellen DeGeneres, donated $100,000, and the program’s host, Ryan Seacrest, went to Africa and cared for dying women and children), the hosts (or program) raised a total of $60 million. Children watching the program asked their parents to give and pledged their own allowances. But is this generosity fleeting, or have children’s beliefs and behaviors been affected in the longer term?

There is also a question about what kind of prosocial portrayal is most effective for different ages. For example, Mares and Woodard (2012) argue that

the combination of aggression and a prosocial theme may be particularly pernicious. That is, showing violence and mayhem in the cause of social justice may be more deleterious to children’s prosocial interactions than showing violence unadulterated by any prosocial theme. (p. 195)

A study by Krcmar and Valkenburg (1999) found that 6- to 12-year-olds could easily reason that “unjustified violence” is wrong in an abstract, hypothetical situation. However, children who were heavy viewers of the fantasy violence program Power Rangers were more likely than light viewers of this show to judge “justified” aggression in the hypothetical scenarios as morally correct. One might argue that children who see the



world in this way (that is, that justified violence is morally right) are drawn to superhero-type shows such as Power Rangers. Krcmar and Curtis (2003) conducted an experiment in which 5- to 14-year-olds were randomly assigned to one of three conditions: One watched an action cartoon that featured characters arguing and eventually engaging in violence; another watched a similar clip involving an argument, but the characters walked away instead of fighting; and a control group did not watch television. Afterward, the subjects listened to and judged four hypothetical stories involving violence. Children who had watched the violent program were subsequently more likely than those in the control group to judge the violence as morally acceptable. They also exhibited less sophisticated moral reasoning in their responses (for example, they relied on punishment as a rationale—“Don’t hit or you’ll get in trouble”).

Not only is much of children’s superhero programming portrayed with conflicting pro- and antisocial messages; so too is the adult programming popular with young audiences. The FOX TV series 24 was roundly criticized for having its hero, Jack Bauer, use torture against his enemies (including his bad-guy brother) to save the world from disaster (Moritz, 2007). Similarly, if one aim is to have children imitate constructive, prosocial behavior, what is the best way to promote that? Should the reward be intrinsic or extrinsic? Should children be shown precisely how to carry this behavior over into their own lives? The program Captain Planet highlighted the ecological problems facing the world—problems that were solved by superheroes called “planeteers.” At the end of the program, however, children were shown exactly what they could do in their own homes and communities to be a “planeteer” too. Behaviors included recycling newspapers, making birdhouses, and picking up litter.

It is clear that research needs to account for the developmental differences of audiences when examining the potential benefits of prosocial content. As Mares and Woodard (2012) point out, “Judgments about what is bad and why it is bad are not the same for a 4 year old and a 10 year old or an adult” (p. 200). Researchers Calvert and Kotler (2003) argue that at least for school-aged children, prosocial program content is even more “educational” than academic-oriented shows that feature science, literature, or math. As Jordan (2003) points out, however, it is difficult to know whether the children remember the lessons better because they have been ingrained in them since they were toddlers (share, be nice, etc.) or whether it is because the narrative structure is more entertaining and engaging. Children’s interpretations of content, as well as the capacity of such content


to be assimilated into existing cognitive schemes, are critical factors in understanding the effects of prosocial media.

Prosocial Media for Adolescents The great majority of research on prosocial effects of media has involved

children, especially very young children (Hogan, 2012b; Hogan & Strasburger, 2008). Only a handful of studies and experiments have specifically examined the possibility of prosocial effects of media on adolescents (Mares & Woodard, 2005). As noted earlier, a meta-analysis of studies examining the effects of prosocial television content found that effects of prosocial television dropped off after the age of 7 (Mares & Woodard, 2005). However, new technology is bringing a whole variety of new ways to reach teenagers with prosocial content, and evaluations suggest that such content may have beneficial effects on adolescent health and well- being.

Prosocial Messages and Outcomes in New Media Technologies Research with interactive media shows great promise for the positive

benefits of media use by adolescents in both the short term and long term (C.A. Anderson, Gentile, & Dill, 2012; Gentile et al., 2009; Greitemeyer & Osswald, 2010; Prot, McDonald, Anderson, & Gentile, 2012). Recently, the Robert Wood Johnson Foundation funded an $8.25 million initiative to advance the research and design of digital games that promote health ( A number of new video and computer games have been developed with applications for adolescents with the goal of increasing their physical health and social well-being. Examples include the following:

• Packy and Marlon is a video game in which two diabetic elephants stroll through the jungle, trying to pick the right foods, checking their blood glucose levels, and giving themselves insulin shots. A six- month study of 60 diabetic children and teens found that those who used the video game were four times less likely to require urgent care visits than were those who played another popular video game (“Managing Ailments,” 1999). Some health care organizations, like Kaiser, actually pay for such games for their patients.

• A computer-based intervention that pairs adolescent users’ self-



concept with images of warm social acceptance has been shown to temper adolescents’ tendency to react to social rejections with aggressiveness, particularly for subjects with low self-esteem (Baldwin, Baccus, & Milyavskaya, 2010).

• A video game titled Re-Mission (HopeLab, Palo Alto, CA) has been developed for cancer patients and features a “nanobot” named Roxxi, an attractive character who travels through the body blasting away at cancer cells. In a study of 375 cancer patients (ages 13 to 29 years) at 34 different medical centers, those who played the game were more compliant with chemotherapy and antibiotic treatments (Beale, Kato, Marin-Bowling, Guthrie, & Cole, 2007).

• Dance Dance Revolution (see Figure 3.9) is a popular video game that encourages exercise at home and can double energy expenditure (Lanningham-Foster et al., 2006). While some researchers found no reduction in body mass index among children who used it (Madsen, Yen, Wlasiuk, Newman, & Lustig, 2007), others found that exergames can increase energy expenditure four to eight times over resting levels among adolescents who engage in moderate to vigorous participation (Bailey & McInnis, 2011; Smallwood, Morris, Fallows, & Buckley, 2012). The key may be the intensity level of physical exercise (O’Loughlin, Dugas, Sabiston, & O’Loughlin, 2012). Other games, like Body Mechanics, teach children to avoid becoming obese by allying themselves with a team of superheroes to battle villains such as Col Estorol and Betes II (Ellis, 2007).

• An in-home virtual reality video game has been shown to improve hand function and forearm bone health in adolescents with hemiplegic cerebral palsy (Golomb et al., 2010). Similarly, a breath-controlled video game that uses biofeedback has been used to promote better breathing in children with cystic fibrosis (Bingham, Bates, Thompson-Figueroa, & Lahiri, 2010).

• Video games like The Baby Game and It’s Your Game: Keep It Real have potential to decrease teen pregnancy by changing attitudes about unsafe sex (Hogan, 2012b).

• An extensive review of the literature found 38 studies that used video games to provide physical therapy, psychological therapy, improved disease self-management, or increased physical activity. The range of success was 37% to 69% improvement in outcomes. However, the authors point out that many of the studies in the review used methodology that was not rigorous, and unfortunately had limited


follow-up periods (Primack et al., 2012).

Beyond gaming, digital technology is also increasingly being used in Web-based platforms, cell phone texting, and social networking sites (Boyar, Levine, & Zensius, 2011; Ybarra, 2013, in press). For example, using digital technology has been shown in small studies to delay initiation of sex, remove sexual references from social network profiles, and alter attitudes about condom use among teens and young adults (Collins, Martino, & Shaw, 2011; Guse et al., 2012; Moreno & Kolb, 2012). Other examples include the following:

Figure 3.9 Dance Dance Revolution for PlayStation.

• A 16-week online intervention succeeded in producing weight loss and a reduction in binge eating for a small group of adolescents (Jones et al., 2008).

• A randomized controlled trial of 170 adolescents with depression found that a computerized intervention—an interactive fantasy game called SPARX (Smart, Positive, Active, Realistic, X-factor thoughts) —reduced depressive symptoms as much as or more than face-to-face treatment (Merry et al., 2012). College freshmen whose Facebook profiles reference depression want their friends to respond in person, according to another study (Whitehill, Brockman, & Moreno, 2013).

• Puff City, a Web-based asthma intervention for urban teens, improved


symptoms and decreased school absences in a year-long study of 422 students (Joseph et al., 2012).

• A randomized clinical trial using an Internet obesity prevention program for adolescents decreased sedentary behavior and increased healthy eating and activity in a six-month study of 384 teenagers (Whittemore, Jeon, & Grey, 2012).

• A text message reminder has been used to increase the rate of influenza vaccination in a low-income, urban pediatric population (Stockwell et al., 2012).

• In San Francisco, the Department of Public Health has become the first in the country to begin sending safer-sex text messages to young people who request them (Allday, 2006).

• More recently, in California, more than 3,000 teens signed up for Hook Up (Carroll & Kirkpatrick, 2011), which provides facts about reproductive health and referrals to youth-oriented clinical medical services.

• Delivering sexually transmitted infection (STI) prevention messages via Facebook actually increased condom use over two months in a recent study of 1,578 teens (Bull, Levine, Black, Schmiege, & Santelli, 2012).

• A computer-delivered HIV/AIDS program resulted in increased condom use in a randomized trial with 157 college students (Kiene & Barta, 2006).

• A Web-based program to help teens suffering from chronic fatigue syndrome showed success in treating symptoms. In a randomized controlled trial of 135 teens, 85% of the teens who used the Web- based program reported their fatigue was gone after six months compared with 27% of the control subjects (Nijhof, Bleijenberg, Uiterwaal, Kimpen, & van de Putte, 2012).

A number of private and federally funded programs have incorporated Web-based and online approaches for sex education and prevention of HIV and other STIs (Delgado & Austin, 2007; Whiteley, Mello, Hunt, & Brown, 2012). In particular, using cell phones and texting may represent an important and innovative way to reach teens with preventive health information (Perry et al., 2012). As part of its “Staying Alive” campaign, MTV developed an iPhone app that searches via GPS for the nearest place that sells condoms (Sniderman, 2011). MTV has also developed a “GYT” (Get Yourself Tested) campaign that uses text messaging to locate nearby


clinics for testing and a website with videos that promote and normalize open communication with partners and providers about sexually transmitted diseases (STDs) and testing ( (Kaiser Family Foundation, 2012) (see Figure 3.10). Some experts think that an app will soon be developed for Facebook that will notify users about their risk of a sexually transmitted infection based on their friend’s status updates (Clark-Flory, 2012). Researchers are already using Facebook for partner notification in HIV infections (Clark-Flory, 2012).

Figure 3.10 Get Yourself Tested website (

National and International Prosocial Efforts Evidence is increasing that well-conceived health campaigns involving

the media can have a demonstrable impact (Noar, 2006). One of the earliest prosocial experiments was conducted in Mexico by Miguel Sabido. His telenovela, Acompáñame (Accompany Me), featured a young woman with two children who decided that she did not want any more pregnancies and therefore needed contraception. The show was immensely popular, and sales of contraceptives increased 23% in the first year the show aired, compared with 7% the year before the show began (Brink, 2006). Radio soap operas, in which characters discuss the problems of dealing with the risk of AIDS, have also been used to convey public health messages in India, China, and Africa (Singhal & Rogers, 1999). In Zambia, a media campaign to reduce the risk of HIV resulted in a doubling of condom use among those teenagers who viewed at least three TV ads from the campaign


(Underwood, Hachonda, Serlemitsos, & Bharath-Kumar, 2006). In 2006, the African Broadcast Media Partnership Against HIV/AIDS began a three- to five-year campaign involving a series of PSAs on radio and TV in 25 African countries (Kaiser Family Foundation, 2006). The goal of the campaign, bearing the slogan “An HIV-free generation . . . It begins with you,” is to educate people in Africa about what they can do to stop the spread of HIV. And in China, students have been successfully given sex education via the Internet (Lou, Zhao, Gao, & Shah, 2006).

In the United States, the Kaiser Family Foundation began partnering with MTV in 1997 to produce a total of 62 different PSAs and 19 full-length shows dealing with HIV/AIDS (Rideout, 2003). Kaiser joined with Viacom to get HIV/AIDS storylines incorporated into shows such as Becker, Touched by an Angel, and Queer as Folk (Kaiser Family Foundation, 2004). A RAND study of 506 regular viewers of the hit sitcom Friends found that more than one-fourth could recall seeing one particular episode in which Rachel became pregnant despite the use of a condom. Of those who had viewed the show, 40% had watched the episode with an adult, and 10% had talked with an adult about condom use as a direct result of the show (Collins, Elliott, Berry, Kanouse, & Hunter, 2003). Similarly, a Kaiser survey of more than five hundred 15-to 17-year-olds found that one-third had had a conversation with a parent about a sexual matter because of something they saw on television (see Figure 3.11). In the same survey, 60% of teens said they had learned how to say no to sex by seeing something on TV, and nearly half said that TV had helped them talk to a partner about safe sex (Kaiser Family Foundation, 2002). In 2008, a study showed that viewers of a Grey’s Anatomy episode had learned that HIV-positive mothers could still have HIV-negative babies (Rideout, 2008) (see Figure 3.12).

Other national media campaigns have also tried to increase parent-teen communication about sex (Evans, Davis, Ashley, & Khan, 2012; Palen et al., 2011). For example, an innovative campaign in North Carolina used TV and radio PSAs and billboards to encourage parents to talk to their teenagers about sex. “Talk to your kids about sex. Everyone else is,” was the primary message, and a subsequent survey of 1,132 parents found that the campaign had indeed been effective (DuRant, Wolfson, LaFrance, Balkrishnan, & Altman, 2006).

Community-based campaigns have been effective in reducing the risk of repeated STDs in adolescents who initially test positive for one (Sznitman et al., 2011). Both the National Campaign to Prevent Teen and Unplanned


Pregnancy and Advocates for Youth have run similar campaigns across the nation (see Figure 3.13).

Figure 3.11 Results of study on conversations with parents about sex as a result of watching television.

SOURCE: Kaiser Family Foundation (2002). This information was reprinted with permission from the Henry J. Kaiser Family Foundation. The Kaiser Family Foundation, based in Menlo Park, California, is a nonprofit, private operating foundation focusing on the major health care issues facing the nation and is not associated with Kaiser Permanente or Kaiser Industries.

Figure 3.12 A study of Grey’s Anatomy viewers after an episode involving a pregnant woman who initially thinks she must have an abortion because she is HIV positive (Rideout, 2008). After the doctors educate her, she changes her mind.


SOURCE: Kaiser Family Foundation (2002). This information was reprinted with permission from the Henry J. Kaiser Family Foundation. The Kaiser Family Foundation, based in Menlo Park, California, is a nonprofit, private operating foundation focusing on the major health care issues facing the nation and is not associated with Kaiser Permanente or Kaiser Industries.

Opportunities Presented by New Media Technologies for Children With Learning Differences New technologies such as the iPad and other digital learning devices

have opened up opportunities for learning and growing in the modern era. The educational tools available for children with special needs have been particularly important, as they can be customized to focus instruction and curriculum on those areas where a student needs the greatest amount of assistance (Ayres, Maguire, & McClimon, 2009). Children with dyslexia, for example, have been found to benefit from computer software that recodes words into multisensory representations comprising visual and auditory codes (Kast, Baschera, Gross, Jancke, & Meyer, 2011). In one study, low-performing kindergartners made significantly greater gains in early literacy skills when using computer-assisted instruction to supplement a phonics-based reading curriculum compared to children in typical classrooms (Macaruso & Rodman, 2011).

Figure 3.13 Advocates for Youth ad.


SOURCE: Advocates for Youth ( Reprinted with permission.

Autism presents unique issues for educators and parents, and media can help to support efforts at instruction in both the cognitive and social realms. A systematic review of the use of computer-based interventions (CBI) to teach communication skills to children with autism suggests that initial studies are promising (Ramdoss et al., 2011). Studies have shown that autistic children can learn from computer-based video instruction (CBVI) that leads them through social protocols, such as turn taking (Simpson, Langone, & Ayres, 2004), as well as functional life skills, such as making a sandwich or setting the table (Ayres et al., 2009). Video games that are popular with neurotypical children have also been found to benefit children with autism. In one study, researchers taught children with autism to play Guitar Hero II, and this game playing helped keep children on task. The authors of the study argue that the ability to play games like Guitar Hero can also translate into greater social engagement (Blum-Dimaya, Reeve, Reeve, & Hoch, 2010).

Learning to Learn From Media Children are not born using media. Indeed, as much as children are socialized by media, they are socialized to use media in particular ways. Social psychologist Gavriel Salomon systematically explored how



children’s preconceptions about a medium—for example, that print is “hard” and television is “easy”—shape the amount of mental effort they will invest in processing the medium. This amount of invested mental effort, or AIME, is defined as “the number of non-automatic mental elaborations applied to the material” (Salomon, 1984). AIME, in turn, shapes how much children will take away from the medium; that is, how much they might learn. The contexts of a child’s life will contribute to how “shallowly” or “deeply” he or she will process mediated information (Cohen & Salomon, 1979). For example, comparisons of Israeli children and American children during the 1970s showed that, even when IQ was accounted for, Israeli children learned more from television programming than their American counterparts did. He reasoned that this was because at the time of his studies, Israelis used television primarily as a news source. Salomon also found that the perceived demand characteristics (PDCs) of a medium could be altered. Children who were told that they would be asked questions about what they viewed, or who were told to pay attention because the material was hard, did in fact pay more attention and did in fact learn more (Salomon, 1983).

AIME theory raises the question of how children come to think about media as fulfilling particular uses or gratifying particular needs. Van Evra (1998) suggests that since much of television is entertainment, children develop a particular schema for how much processing is required—a schema that will drive viewing of even educational programming. While preschool programming, particularly that which airs on PBS, has historically had a mission to educate, the past decade has seen a virtual explosion of educational offerings for children—and novel approaches for getting children engaged with the material. Research with the program Blue’s Clues has been an interesting case study. The producers of the program designed the series to be “interactive,” mimicking Mr. Rogers’s (Mister Rogers’ Neighborhood) style of speaking and pausing as though he were talking with the young viewers themselves. Assessments of viewers’ reactions to the series indicate that the program encouraged a novel style of TV watching—one in which preschoolers talk to characters, shout out solutions to problems, and generally “interact” with what is on the screen. These Blue’s Clues–induced viewing styles, moreover, translated to the viewing of other programs, including noninteractive ones such as Cartoon Network’s Big Bag (Crawley et al., 2002).



Conclusion As the amount of content aimed at children proliferates, and as media become connected as transmedia properties, producers have an opportunity to make the most of the “best” of what is available and leverage it for learning. As Lauricella, Gola, and Calvert (2011) have found, media content that contains a socially meaningful character (in their study, the Sesame Street character Elmo) can enhance children’s learning and attention. Children form relationships with onscreen characters, come to trust that they are socially relevant and meaningful, and trust them to be reliable sources of information (Richert, Robb, & Smith, 2011). To be sure, most children learn best from real, live human beings (Krcmar, 2011). Nevertheless, the stresses facing modern families and the fact that many of our schools are resource poor means that much of childhood learning may occur in front of a screen. Educationally beneficial media characters, stories, and curricula can supplement teaching and parenting, encourage toddlers’ exploration, and accommodate children with special learning needs.

Exercises 1. Watch television on Saturday mornings and see if you can find the

educational shows commercial broadcast stations are offering to children (you can tell by the “e/i” symbol that is on the screen throughout the show). Can you tell what the “lesson” of the show is?

2. Sesame Street is the most researched show on television—and also the most enduring. If you haven’t watched it for a while, tune in and see if you can figure out the ways that it has changed.

3. Go to a store or go online to view the kinds of baby-oriented DVDs that are being sold. What are the implicit or explicit educational claims that are being made about the product? As a researcher, how would you test whether there is any evidence to support these claims?

4. One study found that children who were below grade level in reading significantly improved their reading skills by having access to the Internet at home. Think about your own Internet use. How much of the time would you say you spend reading (vs. watching television episodes or movie trailers!)?

5. Design an educational media product for children that you think fills


the gap in the current landscape of offerings for children. The product should be theoretically driven and empirically justified. What does it look like?

6. Where do you draw the line between prosocial messages and what George Orwell described as “mind control” in his novel Nineteen Eighty-Four (Orwell, 1949)? For example, most people agree that, in general, war is bad. Should prime-time shows contain messages about the recent war in Iraq, or would that be “crossing the line”? Should children’s shows such as Sesame Street contain antiwar messages? Messages about terrorism? Where do you draw the line between public health and moralizing?

7. Imagine a version of Sesame Street designed and produced by (a) the Chinese government, (b) Al Jazeera TV, (c) the former Soviet Union, and (d) the state of California. Who would the main characters be? What would some of the main themes be? Try watching The World According to Sesame Street, a documentary showing coproductions from China, Israel/Palestine, and Russia. Are there differences between these shows and the American version?

8. As regular viewers of The Simpsons know, The Itchy & Scratchy Show is a parody of violent children’s cartoons. Like Wile E. Coyote and the Roadrunner, Itchy and Scratchy do little more than pummel each other constantly. After Marge writes a letter to the producer of the show, however, the tone becomes much more prosocial— and dull. Kids began turning off their TV sets and heading outdoors. Can prosocial programming be entertaining as well as educational? Do you think Web-based programs, video games, or social networking sites will be able to make significant improvements in (a) child and adolescent obesity, (b) adolescent drug use, or (c) teen sexual activity?

Notes 1. Every day, on average, children spend nearly four hours (3:51) watching

television (including videos and DVDs); one and three-quarters hours (1:44) listening to the radio or to CDs, tapes, or MP3s; just over one hour (1:02) on the computer outside of schoolwork; and just under one hour (0:49) playing video games. By contrast, children say they read for pleasure (books, magazines, newspapers) 43 minutes a day. These data, collected in 2005 by the Kaiser Family Foundation and based on a national sample of 3rd to 12th graders (Rideout,


Roberts, & Foehr, 2005), suggest the vast potential of media for contributing to children’s cognitive development. This seems particularly true when one contrasts children’s media time with the amount spent hanging out with parents (2:17), doing homework (0:50), or doing chores (0:32) (Rideout et al., 2005).

2. In 2007, Univision received a record fine for labeling a telenovela (Spanish- language soap opera for adults) as educational for children (Ahrens, 2007).


Ahrens, F. (2007, February 25). FCC expected to impose record $24 million fine against Univision. Washington Post. Retrieved from dyn/content/article/2007/02/24/AR2007022401453.html

Allday, E. (2006, April 26). Safer sex info goes high-tech. San Francisco Chronicle, p. B-1.

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 (2nd ed., pp. 249– 272). Thousand Oaks, CA: Sage.

Anderson, D. R., Huston, A. C., Schmitt, K. L., Linebarger, D. L., & Wright, J. C. (2001). Early childhood television viewing and adolescent behavior. Monographs of the Society for Research in Child Development, 68(Serial No. 264), 1–143.

Anderson, D. R., Lorch, E. P., Field, D. E., & Sanders, J. (1981). The effects of TV program comprehensibility on preschool children’s visual attention to television. Child Development, 52, 151–157.

Arnold, D. H., Ortiz, C., Curry, J. C., Stowe, R. M., Goldstein, N. E., Fisher, P. H., . . . Yershova, K. (1999). Promoting academic success and preventing disruptive behavior disorders through community partnership. Journal of Community Psychology, 5, 589–598.

Ayres, K. M., Maguire, A., & McClimon, D. (2009). Acquisition and generalization of chained tasks taught with computer based video instruction to children with autism. Education and Training in Developmental Disabilities, 44(4), 493–508.

Bailey, B. W., & McInnis, K. (2011). Energy cost of exergaming: A comparison of the energy cost of 6 forms of exergaming. Archives of Pediatrics and Adolescent Medicine, 165, 597–602.


Baldwin, M. W., Baccus, J. R., & Milyavskaya, M. (2010). Computer game associating self-concept to images of acceptance can reduce adolescents’ aggressiveness in response to social rejection. Cognition and Emotion, 24(5), 855–862.

Barr, R., Lauricella, A., Zack, E., & Calvert, S. (2010). Infant and early childhood exposure to adult-directed and child-directed television programming: Relations with cognitive skills at age four. Merill-Palmer Quarterly, 56(1), 21–48.

Beal, C., & Arroyo, I. (2002). The AnimalWatch project: Creating an intelligent computer mathematics tutor. In S. Calvert, A. Jordan, & R. Cocking (Eds.), Children in the digital age: Influences of electronic media on development (pp. 183–198). Westport, CT: Praeger.

Beale, I. L., Kato, P. M., Marin-Bowling, V. M. Guthrie, N., & Cole, S.W. (2007). Improvement in cancer-related knowledge following use of a psychoeducational video game for adolescents and young adults with cancer. Journal of Adolescent Health, 41, 263–270.

Bellin, H., & Singer, D. (2006). My Magic Story Car: Video-based play intervention to strengthen emergent literacy of at-risk preschoolers. In D. Singer, R. Golinkoff, & K. Hirsh-Pasek (Eds.), Play = learning: How play motivates and enhances children’s cognitive and social-emotional growth (pp. 101–123). Oxford, UK: Oxford University Press.

Bingham, P. M., Bates, J. H. T., Thompson-Figueroa, J., & Lahiri, T. (2010). A breath biofeedback computer game for children with cystic fibrosis. Clinical Pediatrics, 49, 337–342.

Blum-Dimaya, A., Reeve, S. A., Reeve, K. F., & Hoch, H. (2010). Teaching children with autism to play a video game using activity schedules and game-embedded simultaneous video modeling. Education and Treatment of Children, 33(3), 351–370.

Boyar, R., Levine, D., & Zensius N. (2011). TECHsex: Youth sexuality and reproductive health in the digital age. Oakland, CA: ISIS.

Brink, S. (2006, November 13). Prime time to learn. Los Angeles Times. Retrieved from media13nov13,1,5874234.story

Bull, S. S., Levine, D. K., Black, S. R., Schmiege, S. J., & Santelli, J. (2012). Social media–delivered sexual health intervention: A cluster randomized controlled trial. American Journal of Preventive Medicine, 43, 467–474.

Calvert, S., & Kotler, J. (2003). Lessons from children’s television: The


impact of the Children’s Television Act on children’s learning. Applied Developmental Psychology, 24, 275–335.

Cantor, J. (2012). The media and children’s fears, anxieties, and perceptions of danger. In D. Singer & J. Singer (Eds.), Handbook of children and the media (2nd ed.). Thousand Oaks, CA: Sage.

Carroll, J. A., & Kirkpatrick, R. L. (2011). Impact of social media on adolescent behavioral health in California. Oakland, CA: Adolescent Health Collaborative.

Children’s Television Act of 1990, Pub. L. No. 101-437, 104 Stat. 996 (codified at 47 U.S.C. 303a-303b (2006)).

Christakis, D. A., Gilkerson, J., Richards, J. A., Zimmerman, F. J., Garrison, M. M., Xu, D., . . . Yapanel, U. (2001). Audible television and decreased adult words, infant vocalizations, and conversational turns. Archives of Pediatrics and Adolescent Medicine, 163(6), 554–558.

Clark-Flory, T. (2012, March 31). Facebook: The next tool in fighting STDs. Salon. Retrieved from

Cohen, A., & Salomon, G. (1979). Children’s literate television viewing: Surprises and possible explanations. Journal of Communication, 29(3), 156–163.

Collins, R. L., Elliott, M. N., Berry, S. H., Kanouse, D. E., & Hunter, S. B. (2003). Entertainment television as a healthy sex educator: The impact of condom-efficacy information in an episode of Friends. Pediatrics, 112, 1115–1121.

Collins, R. L., Martino, S. C., & Shaw, R. (2011). Influence of new media on adolescent sexual health: Evidence and opportunities. Santa Monica, CA: RAND.

Crawley, A. M., Anderson, D. R., Santomero, A., Wilder, A., Williams, M., Evans, M. K., & Bryant, J. (2002). Do children learn how to watch television? The impact of extensive experience with Blue’s Clues on preschool children’s television viewing behavior. Journal of Communication, 52(2), 264–279.

Crawley, A. M., Anderson, D. R., Wilder, A., Williams, M., & Santomero, A. (1999). Effects of repeated exposures to a single episode of the television program Blue’s Clues on the viewing behaviors and comprehension of preschool children. Journal of Educational Psychology, 91, 630–637.

Delgado, H. M., & Austin, S. B. (2007). Can media promote responsible


sexual behaviors among adolescents and young adults? Current Opinion in Pediatrics, 19, 405-410.

DeLoache, J. S., Chiong, C., Sherman, K., Islam, N., Vanderborght, M., Troseth, G. L., . . . O’Doherty, K. (2010). Do babies learn from baby media? Psychological Science, 21(11), 1570–1574.

DuRant, R. H., Wolfson, M., LaFrance, B., Balkrishnan, R., & Altman, D. (2006). An evaluation of a mass media campaign to encourage parents of adolescents to talk to their children about sex. Journal of Adolescent Health, 38, 298.e1–299.e9.

Ellis, J. (2007, February 21). New DVD game battles childhood obesity. Retrieved from

Ennemoser, M., & Schneider, W. (2007). Relations of television viewing and reading: Findings from a 4-year longitudinal study. Journal of Educational Psychology, 99(2), 349–368.

Evans, W. D., Davis K. C., Ashley, O. S., & Khan, M. (2012). Effects of media messages on parent-child sexual communication. Journal of Health Communication, 17, 498–514.

Federal Communications Commission. (1979). Television programming for children: A report of the children’s task force (Vol. 1, at 3).

Federal Communications Commission. (1996). In the matter of policies and rules concerning children’s television programming: Report and order. Federal Communications Commission Record, 11, 10660–10778.

Fein, G. G. (1981). Pretend play in childhood: An integrative review. Child Development, 52, 1095–1118.

Fisch, S., & Bernstein, L. (2001). Formative research revealed: Methodological and process issues in formative research. In S. Fisch & R. Truglio (Eds.), “G” is for growing (pp. 39–60). Mahwah, NJ: Lawrence Erlbaum.

Fisch, S., & Truglio, R. (Eds.). (2001). “G” is for growing. Mahwah, NJ: Lawrence Erlbaum.

Fisch, S., Truglio, R., & Cole, C. (1999). The impact of Sesame Street on preschool children: A review and synthesis of 30 years’ research. Media Psychology, 1, 165–190.

Friedrich-Cofer, L. K., Huston-Stein, A., Kipnis, D. M., Susman, E. J., & Clewett, A. S. (1979). Environmental enhancement of prosocial television content: Effect on interpersonal behavior, imaginative play, and self-regulation in a natural setting. Developmental Psychology, 15, 637– 646.


Garrison, M. (July 24, 2012). Sesame Street steps into Indian education business. Retrieved from steps-indian-education-business

Gentile, D. A., Anderson, C.A., Yukawa, S., Ihori, N., Saleem, M., Ming, L. K., . . . Sakamoto, A. (2009). The effects of prosocial video games on prosocial behaviors: International evidence from correlational, longitudinal, and experimental studies. Personality and Social Psychology Bulletin, 35, 752–763.

Gerbner, G., Gross, L., Signorielli, N., & Morgan, M. (1986). Television’s mean world: Violence profiles No. 14–15. Philadelphia: University of Pennsylvania, Annenberg School of Communications.

Glover, R. J., Garmon, L. C., & Hull, D. M. (2011). Media’s moral messages: Assessing perceptions of moral content in television programming. Journal of Moral Education, 40(1), 89–104.

Golomb, M. R., McDonald, B. C., Warden, S. J., Yonkman, J., Saykin, A. J., Shirley, B., . . . Burdea, G. C. (2010). In-home virtual reality videogame telerehabilitation in adolescents with hemiplegic cerebral palsy. Archives of Physical Medicine and Rehabilitation, 91, 1–8.

Greitemeyer, T., & Osswald, S. (2010). Effects of prosocial video games on prosocial behavior. Journal of Personality and Social Psychology, 98, 211–221.

Guse, K., Levine, D., Martins, S., Lira, A., Gaarde, J., Westmorland, W., & Gilliam M. (2012). Interventions using new digital media to improve adolescent sexual health: A systematic review. Journal of Adolescent Health. doi:10.1016/j.jadohealth.2012.03.014

Healy, J. (1990). Endangered minds: Why our children don’t think. New York, NY: Simon & Schuster.

Hearold, S. (1986). A synthesis of 1043 effects of television on social behavior. In G. Comstock (Ed.), Public communication and behavior (Vol. 1, pp. 65–133). Orlando, FL: Academic Press.

Hogan, M. (2012a). Parents and older adults: Models and monitors of healthy media habits. In D.G. Singer & J. L. Singer (Eds.), Handbook of children and the media (2nd ed., pp. 661–680). Thousand Oaks, CA: Sage.

Hogan, M. (2012b). Prosocial effects of media. Pediatric Clinics of North America, 59, 635–645.

Hogan, M. J., & Strasburger, V. C. (2008). Media and prosocial behavior in


children and adolescents. In L. Nucci & D. Narvaez (Eds.), Handbook of moral and character education. Mahwah, NJ: Lawrence Erlbaum.

Jackson, L. A., von Ey, A., Biocca, F., Barbatsis, G., Zhao, Y., & Fitzgerald, H. (2006). Does home Internet use influence the academic performance of low-income children? Developmental Psychology, 42, 429–435.

Jenkins, H. (2006). Convergence culture: Where old and new media collide. New York, NY: New York University Press.

Johnson, S. (2005). Everything bad is good for you: How today’s popular culture is actually making us smarter. New York, NY: Riverhead.

Jones, M., Luce, K. H., Osborne, M. I., Taylor K., Cunning, D., Celio Doyle, A., . . . Taylor, B. (2008). Randomized, controlled trial of an Internet- facilitated intervention for reducing binge eating and overweight in adolescents. Pediatrics, 121, 453–462.

Jordan, A. (1996). The state of children’s television: An examination of quantity, quality and industry beliefs (Report No. 2). Philadelphia: University of Pennsylvania, Annenberg Public Policy Center.

Jordan, A. (2003). Children remember prosocial program lessons but how much are they learning? [Commentary]. Journal of Applied Developmental Psychology, 24, 341–345.

Jordan, A. (2004). The three-hour rule and educational television for children. Popular Communication, 2(2), 103–119.

Joseph, C. L. M., Ownby, D. R., Havstad, S. L., Saltzgaber, M. S., Considine, S., Johnson, D., … Cole Johnson, C. (2012). Evaluation of a Web-based asthma management intervention program for urban teenagers: Reaching the hard to reach. Journal of Adolescent Health. doi: 10.1016/j.jadohealth.2012.07.009

Kaiser Family Foundation. (2002). Teens, sex and TV. Menlo Park, CA: Author.

Kaiser Family Foundation. (2004). Entertainment education and health in the United States. Menlo Park, CA: Author.

Kaiser Family Foundation. (2006, November 30). African Broadcast Media Partnership Against HIV/AIDS launches coordinated, multi-year media campaign in 25 countries [News release]. Menlo Park, CA: Author.

Kaiser Family Foundation. (2012, April 9). MTV audience encouraged to “GYT” [News release]. Menlo Park, CA: Author.

Kast, M., Baschera, G.M., Gross, M., Jancke, L., & Meyer, M. (2011). Computer-based learning of spelling skills in children with and without dyslexia. Annals of Dyslexia, 61, 177–200.


Kiene, S. M., & Barta, W. D. (2006). A brief individualized computer- delivered sexual risk reduction intervention increases HIV/AIDS preventive behavior. Journal of Adolescent Health, 39, 404–410.

Kirkorian, H. L., Pempek, T. A., Murphy, L. A., Schmidt, M. E., & Anderson, D. (2009). The impact of background television on parent- child interaction. Child Development, 80(5), 1350–1359.

Knowlton, L., & Costigan, L. (Producers/Directors). (2006). The world according to Sesame Street [Documentary]. United States: Participant Productions.

Krcmar, M. (2011). Word learning in very young children from infant- directed DVDs. Journal of Communication, 61, 780–794.

Krcmar, M., & Curtis, S. (2003). Mental models: Understanding the impact of fantasy violence on children’s moral reasoning. Journal of Communication, 53(3), 460–478.

Krcmar, M., & Valkenburg, P. (1999). A scale to assess children’s moral interpretations of justified and unjustified violence and its relationship to television viewing. Communication Research, 26, 608–634.

Kunkel, D. (1998). Policy battles over defining children’s educational television. Annals of the American Academy of Political and Social Sciences, 557, 39–53.

Kunkel, D., & Canepa, J. (1994). Broadcasters’ license renewal claims regarding children’s educational programming. Journal of Broadcasting and Electronic Media, 38, 397–416.

Kunkel, D., & Wilcox, B. (2001). Children and media policy. In D. Singer & J. Singer (Eds.), Handbook of children and the media (pp. 589–604). Thousand Oaks, CA: Sage.

Ladd, G. W., Birch, S. H., & Buhs, E. S. (1999). Children’s social and scholastic lives in kindergarten: Related spheres of influence? Child Development, 70, 1373–1400.

Lanningham-Foster, L., Jensen, T. B., Foster, R. C., Redmond, A. B., Walker, B. A., Heinz, D., & Levine, J. A. (2006). Energy expenditure of sedentary screen time compared with active screen time for children. Pediatrics, 118, e1831–e1835.

Lauricella, A., Gola, A. A., & Calvert, C. (2011). Toddlers’ learning from socially meaningful video characters. Media Psychology, 14(2), 216– 232.

Linebarger, D., Piotrowski, J. T., & Greenwood, C. (2010). On-screen print: The role of captions as a supplemental literacy tool. Journal of


Research in Reading, 33(2), 148–167. Linebarger, D., & Walker, D. (2004). Infants’ and toddlers’ television

viewing and language outcomes. American Behavioral Scientist, 46, 1– 22.

Lou, C.-H., Zhao, Q., Gao, E.-S., & Shah, I. H. (2006). Can the Internet be used effectively to provide sex education to young people in China? Journal of Adolescent Health, 39, 720–728.

Lowery, S. A., & DeFleur, M. L. (1995). Milestones in mass communication research. White Plains, NY: Longman.

Macaruso, P., & Rodman, A. (2011). Efficacy of computer-assisted instruction for the development of early literacy skills in young children. Reading Psychology, 32, 172–196.

Madsen, K. A., Yen, S., Wlasiuk, L., Newman, T. B., & Lustig, R. (2007). Feasibility of a dance videogame to promote weight loss among overweight children and adolescents. Archives of Pediatrics and Adolescent Medicine, 161, 105–107.

Managing ailments through video games. (1999, April 6). New York Times. Retrieved from ailments-through-video-games.html?pagewanted=print&src=pm

Mandler, J. M. (1984). Stories, scripts and scenes: Aspects of schema theory. Hillsdale, NJ: Lawrence Erlbaum.

Mares, M. L., Braun, M. T., & Hernandez, P. (2012). Pessimism and anxiety: Effects of tween sitcoms on expectations and feelings about peer relationships in school. Media Psychology, 15, 121–147.

Mares, M.-L., & Woodard, E. (2001). Prosocial effects on children’s social interactions. In D. G. Singer & J. L. Singer (Eds.), Handbook of children and the media (pp. 183–206). Thousand Oaks, CA: Sage.

Mares, M.-L., & Woodard, E. (2005). Positive effects of television on children’s social interactions: A meta-analysis. Media Psychology, 7, 301–322.

McGonigal, J. (2011). Reality is broken: Why games make us better and how they can change the world. New York, NY: Pengu.

McIntyre, Jeff J. (2013). The political narrative of children’s media research. In K. Dill (Ed.) The Oxford Handbook of Media Psychology (pp. 462–473). New York, NY: Oxford University Press.

McLelland, M. M., Morrison, F. J., & Holmes, D. L. (2000). Children at risk for early academic problems: The role of learning-related social skills. Early Childhood Research Quarterly, 15, 307–329.


McLuhan, M. (1964). Understanding media: The extension of man. New York, NY: McGraw-Hill.

Mendolsohn, A. L., Brockmeyer, C. A., Dreyer, B. P., Fierman, A. H., Serkule-Silberman, S. B., & Tomopoulos, S. (2010). Do verbal interactions with infants during electronic media exposure mitigate adverse impacts on their language development as toddlers? Infant and Child Development, 19(6), 577–593.

Merry, S. N., Stasiak, K., Shepherd, M., Frampton, C., Fleming, T., & Lucassen, M. F. G. (2012). The effectiveness of SPARX, a computerized self help intervention for adolescents seeking help for depression: Randomized controlled non-inferiority trial. British Medical Journal, 344, e2598.

Moreno, M. A., & Kolb, J. (2012). Social networking sites and adolescent health. Pediatric Clinics of North America, 59, 601–612.

Moritz, O. (2007, February 10). Defense bigs ask “24” to cool it on torture. New York Daily News, Sports Final Edition, p. 3.

Naigles, L., & Mayeux, L. (2001). Television as incidental language teacher. In D. Singer & J. Singer (Eds.), Handbook of children and the media (pp. 135–152). Thousand Oaks, CA: Sage.

Nijhof, S. L., Bleijenberg, G., Uiterwaal, C. S. P. M., Kimpen, J. L. L., & van de Putte, E. M. (2012). Effectiveness of Internet-based cognitive behavioural treatment for adolescents with chronic fatigue syndrome (FITNET): A randomized controlled trial. Lancet, 379, 1412–1418.

Noar, S. M. (2006). A 10-year retrospective of research in health mass media campaigns: Where do we go from here? Journal of Communication, 11, 21–42.

Okagaki, L., & Frensch, P. (1994). Effects of video game playing on measures of spatial performance: Gender effects in late adolescence. Journal of Applied Developmental Psychology, 15, 33–58.

O’Loughlin, E. K., Dugas, E. N., Sabiston, C. M., & O’Loughlin, J. L. (2012). Prevalence and correlates of exergaming in youth. Pediatrics, 130, 1–9.

Orwell, G. (1949). Nineteen eighty-four. London, UK: Secker and Warburg. Palen, L. A., Ashley, O. S., Gard, J. C., Kan, M. L., Davis, K. C., & Evans,

W.D. (2011). Effects of media campaign messages targeting parents on adolescent sexual beliefs: A randomized controlled trial with a national sample. Family and Community Health, 34, 28–38.

Palmer, E. (1988). Television and America’s children: A crisis of neglect.


New York, NY: Oxford University Press. Pecora, N. (1998). The business of children’s entertainment. New York,

NY: Guilford. Perry, R. C. W., Kayekjian, K.C., Braun, R.A., Cantu, M., Sheoran, B., &

Chung, P.J. (2012). Adolescents’ perspectives on the use of a text messaging service for preventive sexual health promotion. Journal of Adolescent Health. doi:10.1016/j.jadohealth.2011.11.012

Phillips, A. (2012). A creator’s guide to transmedia storytelling: How to captivate and engage audiences across multiple platforms. New York, NY: McGraw-Hill.

Primack, B. A., Carroll, M. V., McNamara, M., Klem, M. L., King, B., Rich, M.,. . . . Nayak, S. (2012). Role of video games in improving health- related outcomes: A systematic review. American Journal of Preventive Medicine, 42, 630–638.

Prot, S., McDonald, K. A., Anderson, C. A., & Gentile D. A. (2012). Video games: Good, bad, or other? Pediatric Clinics of North America, 59, 647–658.

Ramdoss, S., Lang, R., Mulloy, A., Franco, J., O’Reilly, M., Didden, R., & Lancioni, G. (2011). Use of computer-based interventions to teach communication skills to children with autism spectrum disorders: A systematic review. Journal of Behavioral Education, 20, 55–76.

Raver, C. C. (2002). Emotions matter: Making the case for the role of young children’s emotional development for early school readiness. Social Policy Report, 16(3), 1–18.

Rice, M. (1984). The words of children’s television. Journal of Broadcasting, 28, 445–461.

Rice, M. (1990). Preschoolers’ QUIL: Quick incidental learning of words. In G. Conti-Ransden & C. Snow (Eds.), Children’s language (Vol. 7, pp. 171–194). Hillsdale, NJ: Lawrence Erlbaum.

Richert, R. A., Robb, M. B., & Smith, E. I. (2011). Media as social partners: The social nature of young children’s learning from screen media. Child Development, 82(1), 82–95.

Rideout, V. J. (2003). Reaching the MTV generation: Recent research on the impact of the Kaiser Family Foundation/MTV Public Education Campaign on Sexual Health. Menlo Park, CA: Kaiser Family Foundation.

Rideout, V. (2008). Television as a health educator: A case study of Grey’s Anatomy. Menlo Park, CA: Kaiser Family Foundation.


Rideout, V., Roberts, D., & Foehr, U. (2005). Generation M: Media in the lives of 8–18 year-olds. Menlo Park, CA: Kaiser Family Foundation.

Runco, M. A., & Pezdek, K. (1984). The effect of television and radio on children’s creativity. Human Communication Research, 11, 109–120.

Saarni, C. (1990). Emotional competence: How emotions and relationships become integrated. In R. Thompson (Ed.), Nebraska Symposium on Motivation 1988: Socioemotional development (pp. 115–182). Lincoln: University of Nebraska Press.

Salomon, G. (1983). Television watching and mental effort: A social psychological view. In D. Anderson & J. Bryant (Eds.), Children’s understanding of television: Research on attention and comprehension (pp. 181–198). New York, NY: Academic Press.

Salomon, G. (1984). Television is “easy” and print is “tough”: The differential investment of mental effort as a function of perceptions and attributions. Journal of Educational Psychology, 76, 647–658.

Scantlin, R., & Jordan, A (2006). Families’ experiences with the V-chip: An exploratory study. Journal of Family Communication, 6(2), 139–159.

Schmidt, M. E., Pempek, H. L., Kirkorian, H. L., Lund, A. F., & Anderson, D. R. (2008). The effects of background television on the toy play behavior of very young children. Child Development, 79(4), 1137–1151.

Simpson, A., Langone, J., & Ayres, K. M. (2004). Embedded video and computer-based instruction to improve social skills for students with autism. Education and Training in Developmental Disabilities, 39, 240– 252.

Singer, J. L., & Singer, D. G. (1976). Can TV stimulate imaginative play? Journal of Communication, 26(3), 74–80.

Singer, J. L., & Singer, D. G. (1998). Barney & Friends as entertainment and education: Evaluating the quality and effectiveness of a television series for preschool children. In J. K. Asamen & G. Berry (Eds.), Research paradigms, television, and social behavior (pp. 305–367). Beverly Hills, CA: Sage.

Singer, J. L., Singer, D. G., & Rapaczynski, W. S. (1984). Family patterns and television viewing as predictors of children’s beliefs and aggression. Journal of Communication, 34(2), 73–89.

Singhal, A., & Rogers, E. M. (1999). Entertainment-education: A communication strategy for social change. Mahwah, NJ: Lawrence Erlbaum.

Smallwood, S. R., Morris, M. M., Fallows, S. J., & Buckley, J. P. (2012).


Physiologic responses and energy expenditure of Kinect active video game play in schoolchildren. Archives of Pediatrics and Adolescent Medicine, 166, 1005–1009.

Smith, S. W., Smith, S. L., Pieper, K. M., Yoo, J. H., Ferris, A. L., Downs, E., & Bowden, B. (2006). Altruism on American television: Examining the amount of, and context surrounding, acts of helping and sharing. Journal of Communication, 56, 707–727.

Sniderman, Z. (2011, August 9). MTV app locates places to get condoms. Retrieved from

Sprafkin, J. N., Liebert, R. M., & Poulos, R. W. (1975). Effects of a prosocial televised example on children’s helping. Journal of Experimental Child Psychology, 20, 119–126.

Stockwell, M.S., Olshen Kharbanda, E., Andres Martinez, R., Vargas, C. Y., Vawdrey, D. K., & Camargo, S. (2012). Effect of a text messaging intervention on influenza vaccination in an urban, low-income pediatric and adolescent population: A randomized controlled trial. Journal of the American Medical Association, 307, 1702–1708.

Subrahmanyam, K., & Greenfield, P. (1994). Effect of video game practice on spatial skills in girls and boys. Journal of Applied Developmental Psychology, 15, 13–32.

Sznitman, S., Stanton, B. F., Vanable, P. A., Carey, M. P., Valois, R. F., Brown, L. K., . . . Romer, D. (2011). Long term effects of community- based STI screening and mass media HIV prevention messages on sexual risk behaviors of African American adolescents. AIDS and Behavior, 15, 1755–1763.

Thomas, R. M. (2005). Comparing theories of child development (6th ed.). Belmont, CA: Thomson Wadsworth.

Truglio, R. T., Lovelace, V. O., Segui, I., & Schneider, S. (2001). The varied role of formative research: Case studies from 30 years. In R. Truglio & S. Fisch (Eds.), “G” is for growing. Mahwah, NJ: Lawrence Erlbaum.

Turow, J. (1981). Entertainment, education and the hard sell: Three decades of network children’s television. New York, NY: Praeger.

Underwood, C., Hachonda, H., Serlemitsos, E., & Bharath-Kumar, U. (2006). Reducing the risk of HIV transmission among adolescents in Zambia: Psychosocial and behavioral correlates of viewing a risk- reduction media campaign. Journal of Adolescent Health, 38, 55e1– 55e13.

Valkenburg, P. (2001). Television and the child’s developing imagination. In


D. Singer & J. Singer (Eds.), Handbook of children and the media (pp. 121–134). Thousand Oaks, CA: Sage.

Valkenburg, P., & Beentjes, J. (1997). Children’s creative imagination in response to radio and television stories. Journal of Communication, 47(2), 21–38.

Van Evra, J. (1998). Television and child development. Mahwah, NJ: Lawrence Erlbaum.

Wentzel, K. R., & Asher, S. R. (1995). The academic lives of neglected, rejected, popular, and controversial children. Child Development, 66, 754–763.

Whitehill, J. M., Brockman, L. N., & Moreno, M. A. (2013). “Just talk to me”: Communicating with college students about depression disclosures on Facebook. Journal of Adolescent Health, 52, 122–127.

Whiteley, L. B., Mello, J., Hunt, O., & Brown, L. K. (2012). A review of sexual health Web sites for adolescents. Clinical Pediatrics, 51, 209– 213.

Whittemore, R., Jeon, S., & Grey, M. (2012). An Internet obesity prevention program for adolescents. Journal of Adolescent Health. doi: 10.1016/j.jadohealth.2012.07.014

Wilson, B. J., & Cantor, J. (1985). Developmental differences in empathy with a television protagonist’s fear. Journal of Experimental Child Psychology, 39, 284–299.

Wilson, B. J., Kunkel, D., & Drogos, K. L. (2008). Educationally insufficient? An analysis of the availability and educational quality of children’s E/I programming. Retrieved from

Wright, J., St. Peters, M., & Huston, A. (1990). Family television use and its relation to children’s cognitive skills and social behavior. In J. Bryant (Ed.), Television and the American family (pp. 227–251). Hillsdale, NJ: Lawrence Erlbaum.

Ybarra, M. (2013, in press). Technology and public health interventions. In A. Jordan & D. Romer (Eds.). Media and the well-being of children and adolescents. New York: Oxford University Press.



Media Violence

True, media violence is not likely to turn an otherwise fine child into a violent criminal. But, just as every cigarette one smokes increases a little bit the likelihood of a lung tumor someday, every violent show one watches increases just a little bit the likelihood of behaving more aggressively in some situation.

—Psychologists Brad J. Bushman and L. Rowell Huesmann in Handbook of Children and the Media (2001, p. 248)

It’s easy to fall into the trap of thinking that young people emulate literally what they see in entertainment. That if they like a rapper who insults gays, then they must be learning hostility to gays, and if they love a movie hero who defeats villainy with a gun, then they must be learning to solve problems with violence. Anthropologists and psychologists who study play, however, have shown that there are many other functions as well—one of which is to enable children to pretend to be just what they know they’ll never be.

—Gerard Jones Killing Monsters: Our Children’s Need for Fantasy, Heroism, and

Make-Believe Violence (2002, p. 11)

We find it harder, though, to shield our children from the relentless, in- your-face glorification of violence promoted on our TV screens and in the movies. It’s everywhere, and you can’t seem to find the remote fast enough.

—Representative Kevin Brady (R-TX.) as quoted in the New York Times (Lichtblau, 2013)

Media violence isn’t going to disappear and most current efforts to stop it are unlikely to succeed. Like displays of material excess and

gratuitous sex, violence exists within a commercial structure predicated on a powerful system of fantasies.

—David Trend The Myth of Media Violence:



A Critical Introduction (2007, p. 10)

iolence in America threatens the very fabric of contemporary society. In 2010 alone, over 1.2 million violent crimes occurred in this country, which breaks down into one murder every 35 minutes, one forcible rape every six minutes, one robbery every minute, and one aggravated assault every 40 seconds (U.S. Department of

Justice, 2011). Looking just at young people, homicide is the second leading cause of death among 10- to 24-year-olds (Centers for Disease Control and Prevention [CDC], 2010). Every day, 16 children in this country are murdered, and 82% of these youth are killed with firearms (CDC, 2006). Despite a drop in violent crime since the 1990s, the United States still ranks first among industrialized nations in homicides (United Nations Office on Drugs and Crime, 2012). The statistics are certainly troubling, but so are the national tragedies involving homicide. The Newtown, Connecticut, massacre of 20 young children and 6 school staff members is only one recent incident in a deluge of shootings in America over the past decade. The fact that several of these shootings have occurred in schools heightens our sense of vulnerability for our youth (Toppo, 2007). Responding to the 2012 movie theater killings in Aurora, Colorado, Chicago-based journalist Robert Koehler (2012) argued,

The U.S. is far more violent than other developed countries, for reasons seldom addressed or even looked at in anything like a holistic way. The root of the matter, as I see it, is our false distinction between “good violence” and “bad violence.” We don’t address the issue systemically because of our social investment in “good violence” and the enormous payoff it delivers to some. But good violence—the authorized, glorified, “necessary” kind—inevitably morphs into bad violence from time to time, and thus we are delivered jolts of headline-grabbing horror on a regular basis.

As violence continues to permeate our society, government officials, health professionals, educators, and scientists struggle to understand the complex causes of human aggression. To be sure, no single factor propels a person to become violent. Neurological and hormonal abnormalities (Carré, McCormick, & Hariri, 2011), deficiencies in cognitive functioning (Dodge & Pettit, 2003), and even parental violence (Moretti, Obsuth, Odgers, & Reebye, 2006) have been linked to aggression. So have social forces such as poverty, drugs, and the availability of guns (Archer, 1994; Vaughn et al., 2012). Another factor that continually emerges in public debates about


violence is the role of the media. Public opinion polls over the years indicate that most American adults believe that TV and movie violence contributes to real-world crime and aggression (Common Sense Media/Center for American Progress, 2013), and that Hollywood should do more to reduce violence in entertainment programming (Lowry, 1997). Being a parent seems to heighten these concerns. In one poll, 90% of parents with children younger than age 7 believed that TV violence had a serious negative impact on their children (Benton Foundation, 2005).

Are the media part of the problem, or do they merely reflect the violence that is occurring in society? Is media violence chiefly a form of entertainment that dates back to the ancient Greeks, or is it a cultural tool that serves to legitimate violent means of power and social control? There are many opinions about the topic of media violence, and we cannot possibly resolve all of the issues in a single chapter. Consistent with the approach taken throughout this book, we will focus primarily on social scientific research regarding media violence and youth.

There are hundreds of published studies on the impact of media violence. Researchers who have comprehensively reviewed these studies argue quite conclusively that media violence can have antisocial effects (Anderson et al., 2003; Comstock & Powers, 2012; Huesmann, 2007). A 2001 report on youth violence by the surgeon general stated that “research to date justifies sustained efforts to curb the adverse effects of media violence on youths” (U.S. Department of Health and Human Services, 2001). In recent years, several professional organizations have also examined the evidence and concurred that screen violence is harmful to children (e.g., American Academy of Pediatrics, 2009; American Medical Association, 2008).

This chapter begins by addressing the issue of how much violence exists in American media. Then we turn to the question of whether media violence appeals to young people. Next we will give an overview of the research regarding three potential harmful effects of exposure to media violence: (a) the learning of aggressive attitudes and behaviors, (b) desensitization, and (c) fear. As an important contrast, we will present some of the views of critics who disagree with this research. We will conclude with brief sections on guns and the media, suicide and the media, violence in Japan for cross-cultural comparison, and the prosocial effects of media violence on youth.


How Violent Are American Media? American television and movies provide young people with a relentless diet of violent content. Conservative estimates have indicated that the average child or teenager in this country views 1,000 murders, rapes, and aggravated assaults per year on television alone (Rothenberg, 1975). A review by the American Psychological Association put this figure at 10,000 per year—or approximately 200,000 by the time a child reaches the teenage years (Huston et al., 1992). This statistic is likely to be even higher if a child concentrates her or his viewing on certain channels and types of programming, as we will see below.

In one of the earliest efforts to quantify violence on television, George Gerbner and his colleagues analyzed a week of programming each year from 1967 until the late 1980s (e.g., Gerbner, Gross, Morgan, & Signorielli, 1980; Gerbner, Signorielli, Morgan, & Jackson-Beeck, 1979). Looking at the three major broadcast networks, the researchers found a great deal of consistency over time, with roughly 70% of prime-time programs and 90% of children’s programs containing some violence (see Signorielli, 1990). The rate of violence was fairly steady, too, with 5 violent actions per hour featured in prime time and 20 actions per hour in children’s shows (see Figure 4.1).

In the late 1990s, the National Television Violence Study (NTVS) assessed violence on broadcast as well as cable television (Smith et al., 1998; Wilson et al., 1997, 1998). In this large-scale content analysis, researchers randomly selected programming during a nine-month period across 23 channels from 6:00 a.m. to 11:00 p.m., seven days a week. This method produced a composite week of television consisting of more than 2,500 hours of content each year. For three consecutive years (1996–1998), the researchers found that a steady 60% of all programs contained some violence. However, violence varied a great deal by channel type. More than 80% of the programs on premium cable channels featured violence, whereas fewer than 20% of the programs on public broadcasting did (see Figure 4.2). More recent studies continue to confirm the overall NTVS finding that a majority of television programs feature some physical aggression (Glascock, 2008; Linder & Lyle, 2011). But violence in the media is not all the same. To illustrate, compare a film such as Schindler’s List, about the brutality of the Holocaust, with a movie such as 300, a box office hit featuring a group of buffed-up Spartan soldiers in prolonged, blood-


spraying battles against a Persian army. One movie shows the tragic consequences of brutality, whereas the other seems to celebrate or at least condone violence. The NTVS assessed how often violence is shown in a way that can be educational to viewers. Despite the overall pervasiveness of violence, less than 5% of violent programs featured an antiviolence theme across the three years of the study (Smith et al., 1998).

Figure 4.1 Violence in prime-time and children’s programming based on annual content analyses by George Gerbner and colleagues.

SOURCE: Adapted from Signorielli (1990).

Figure 4.2 Proportion of programs containing violence by channel type.


SOURCE: Adapted from Smith et al. (1998).

The researchers also examined contextual features of violence, such as who commits the aggression, whether the violence is rewarded or punished, and whether it results in negative consequences. The study drew several conclusions from the findings:

Violence on television is frequently glamorized. Nearly 40% of the violent incidents were perpetrated by “good” characters who can serve as role models for viewers. In addition, a full 71% of violent scenes contained no remorse, criticism, or penalty for violence. Violence on television is frequently sanitized. Close to half of the violent incidents on television showed no physical harm or pain to the victim. Furthermore, less than 20% of the violent programs portrayed the long- term negative repercussions of violence for family and friends of the victim. Violence on television is often trivialized. More than half of the violent incidents featured intense forms of aggression that would be deadly if they were to occur in real life. Yet despite such serious aggression, 40% of the violent scenes on television included some type of humor.

As we will see below, all of these contextual features increase the


chances that media violence will have a harmful effect on the audience.

Of course, the patterns outlined here characterize all programming taken together, not necessarily the shows that young people spend most of their time viewing. In subsequent analyses of the NTVS sample, researchers looked specifically at two genres that are popular among youth: programs targeted specifically to children younger than 12 (Wilson, Smith, et al., 2002) and music videos (Smith & Boyson, 2002).

In programs targeted to children, nearly all of which are cartoons, violence is far more prevalent. For example, roughly 7 out of 10 children’s shows contained some violence, whereas 6 out of 10 nonchildren’s shows did (Wilson, Smith, et al., 2002). Furthermore, a typical hour of children’s programming contained 14 different violent incidents, or one incident every four minutes. In contrast, nonchildren’s programming featured about six violent incidents per hour, or one every 12 minutes. The researchers also found that children’s programs were substantially more likely than other types of programming to depict unrealistically low levels of harm to victims compared with what would happen in real life. This pattern is particularly problematic for children younger than age 7, who have difficulty distinguishing reality from fantasy (see Chapter 1) and may assume such aggression is harmless. Finally, when children’s shows were divided into categories, superhero cartoons such as Exosquad and Spider-Man as well as slapstick cartoons such as Animaniacs and Road Runner were far more saturated with violence than were social relationship cartoons such as Care Bears and Rugrats (Wilson, Smith, et al., 2002). Magazine-formatted shows such as Barney & Friends, Blue’s Clues, and Bill Nye the Science Guy rarely contained any violence at all.

Looking at music videos, which are popular with preteens and teens, the overall prevalence of violence is quite low (Smith & Boyson, 2002). In one study, only 15% of all videos featured in a typical week of television on BET, MTV, and VH1 contained violence. However, violence varied by music genre. As seen in Figure 4.3, rap and heavy metal videos were more likely to contain violence than other genres were. In fact, nearly one in three rap videos featured physical aggression. The violence in rap videos was also more likely to involve repeated acts of aggression against the same target. More recently, Hunnicutt and Andrews (2009) analyzed the lyrics of 329 rap songs that were popular from 1989 to 2000. Overall, about a third of the songs contained at least one reference to homicide. Notably, homicide-related lyrics increased over time; by 1998, homicide was


mentioned in 42% of the popular songs. The researchers also analyzed the way in which homicide was portrayed. They found that rap lyrics portrayed violent death as a common occurrence and often depicted it in a glorified way.

What about violence in other media? Chapter 10 focuses on video games, so we will not include that medium here. Two studies focused particularly on movies marketed to children. Yokota and Thompson (2000) analyzed G- rated animated films released between 1937 and 1999. All 74 movies in the sample contained at least one act of physical aggression. Furthermore, there was a significant increase in the duration of screen violence over the 40- year period. A classic theme in many of the movies was the good guy triumphing over the bad guy by using physical force. A subsequent study by the same authors revealed that G-rated films that were animated actually contained more violence than those that were not animated did (Thompson & Yokota, 2004). For both television and movies, then, animated content is some of the most violent fare on the market.

Figure 4.3 Prevalence of violence in different genres of music videos.

SOURCE: Adapted from Smith and Boyson (2002).

A recent study has looked at movies for all ages, not just children. Bleakley, Jamieson, and Romer (2012) analyzed over 800 top-grossing films from 1950 to 2006. The researchers found that a whopping 89%


contained violence and that the proportion of characters, both male and female, involved in violence steadily increased over time. Similarly, a study of 77 top PG-13 movies found that 90% were “permeated” with violence, and yet two-thirds of these films were assigned the rating of PG-13 for reasons other than violence (Webb, Jenkins, Browne, Afifi, & Kraus, 2007).

The statistics presented here demonstrate what many people increasingly recognize—there is a great deal of violence in screen entertainment (see Figure 4.4). And today, there are numerous television networks and other screen-based technologies (e.g., computers, iPods) available for young people to find and experience such content. Furthermore, much of this violence is portrayed in formulaic ways that glamorize, sanitize, and trivialize aggression. Finally, violence is particularly prevalent in many of the very products that are targeted to younger audiences. Indeed, a recent study found that even best-selling novels for teens are ripe with violence (Coyne et al., 2011)!

Figure 4.4 Violence in screen media targeted to youth.


Does Media Violence Attract Youth? Writers and producers often claim that there would be less violence in the media if people would stop being attracted to it. Certainly we can think of many films and television shows that have drawn huge audiences and are brimming with violence. Horror films such as Scream and the sequels of Paranormal Activity are examples that have been extremely popular among teenagers. And the success of Lego Ninjago: Masters of Spinjitzu, The Legend of Korra, and Looney Tunes demonstrates that violent programming can be popular with children too.

But does violence ensure that a movie or TV show will be appealing? One way to answer this question is to look at viewership statistics. Hamilton (1998) analyzed Nielsen ratings for more than 2,000 prime-time TV movies airing on the four major broadcast networks between 1987 and


1993. After controlling for factors such as the channel and the time the movie aired, the popularity of the program preceding the movie, and the amount of advertising in TV Guide, he found that movies about murder or about family crime did in fact have higher household ratings. He also found that films explicitly described in TV Guide as “violent” attracted higher viewership as measured by household ratings. Yet despite all the factors Hamilton controlled for, there are still many differences among movies that could account for their varying popularity.

Other researchers have exposed viewers to different programs to determine whether those with violence are rated as more appealing (Diener & Woody, 1981; Greenberg & Gordon, 1972). Even with this methodology, it is difficult to tease out the role that violence plays in enhancing appeal, given that programs differ on so many other dimensions. What is needed is a controlled study that varies the level of violence while holding all other program features constant. Berry, Gray, and Donnerstein (1999) did just that. In a series of three experiments, the researchers left a movie intact or cut specific scenes of graphic violence from it. Across all three studies, undergraduates rated the cut versions as less violent than the uncut versions. The presence of violence also influenced enjoyment, but the findings differed by the sex of the student. Cutting violence from a full-length movie actually increased women’s enjoyment of the content, but it decreased men’s ratings of enjoyment.

Yet two more recent studies involving television programming contradict this pattern. In a large-scale experiment, Weaver and Wilson (2009) edited episodes from five different prime-time TV dramas (e.g., The Sopranos, Oz, 24) to create three versions of each: a version with graphic violence, a version with sanitized violence, and a version with no violence. Across all five episodes, undergraduates enjoyed the nonviolent version significantly more than either of the violent ones. This pattern held true for both males and females, regardless of the graphicness of the content or the participants’ preexisting aggressive tendencies.

In a follow-up experiment, Weaver, Jensen, Martins, Hurley, and Wilson (2011) decided to test whether it might be action rather than violence that viewers find most appealing. The researchers created four different versions of an original, slapstick cartoon using animation software: one low in both action and violence, one low in action but high in violence, one high in action but low in violence, and one high in both action and violence. A total of 128 elementary school children were randomly assigned to watch


one of the four versions. The researchers found that violence had no impact on children’s liking of the cartoon. Instead, action increased liking of the cartoon, but only for boys and not for girls. In other words, boys liked the high-action versions better than the low-action versions of the same cartoon. The findings challenge the idea that violence in and of itself is appealing to children.

Other evidence pertaining to children corroborates this idea. In an early random survey of parents in Madison, Wisconsin, nearly 30% named the Mighty Morphin Power Rangers as their elementary schoolers’ favorite TV show (Cantor & Nathanson, 1997). Nevertheless, the family situation comedy Full House was more often cited as a favorite. A look at more recent Nielsen ratings reveals that violent cartoons such as Planet Sheen and T.U.F.F. Puppy are quite popular among 2- to 11-year-olds, especially during the Saturday morning time block (see Table 4.1). However, family movies such as Tinker Bell and the Great Fairy Adventure, teen sitcoms such as iCarly, and reality shows such as American Idol rank high when the prime-time hours are considered.

Table 4.1 Top Programs Among Children Ages 2–11: 2010–2011 Season


SOURCE: Rankings are based on national ratings from Nielsen Media Research for the 2010–2011 season. Copyrighted information of Nielsen, licensed for use herein.

These types of divergent patterns have led several researchers to conclude that violence is not necessarily always attractive (Cantor, 1998; Goldstein, 1999; Zillmann, 1998). Instead, the appeal of violence seems to depend on several factors, including the nature of the aggression involved. For example, undergraduates who were exposed to a graphic documentary- style film portraying the bludgeoning of a monkey’s head or the slaughtering of steer uniformly found the content disgusting, and most chose to turn the television off before the program ended (Haidt, McCauley, & Rozin, 1994). More recently, Weaver and Wilson (2009) found that graphic violence


produced greater feelings of disgust and other negative emotions among undergraduates than sanitized violence did. On the other hand, brutal violence against a vicious villain who deserves to be punished can be enjoyable (see Zillmann, 1998).

The appeal of violence not only depends on its form but also on the type of viewer involved. A large body of research documents that there are sex differences in attraction to violence (see Cantor, 1998). Compared with girls, boys are more likely to select violent fairytale books (Collins- Standley, Gan, Yu, & Zillmann, 1996), seek out violent movies at the theater (Sargent et al., 2002), play violent video games (Funk, Buchman, & Germann, 2000), and play with violent toys (Servin, Bohlin, & Berlin, 1999). Various theories have been posited for these patterns, some focusing on gender-role socialization and others on biological differences between the sexes (see Oliver, 2000). Nevertheless, greater attraction to media violence among males is not merely a childhood phenomenon—it persists into adolescence and adulthood (Hamilton, 1998; Johnston, 1995).

Certain viewers possess personalities that seem to draw them to media violence as well. Zuckerman (1979) has argued that individuals vary in their need for arousal and that those high on “sensation seeking” will generally seek out novel and stimulating activities. Indeed, studies show that sensation seeking does predict exposure to violent television shows, movies, and even violent websites among adolescents and adults (Aluja- Fabregat, 2000; Slater, 2003; Xie & Lee, 2008). Moreover, sensation seeking is positively related to the enjoyment of graphic horror films (Tamborini & Stiff, 1987; Zuckerman & Litle, 1986). High sensation seeking among teens has even been linked to a preference for listening to heavy metal music (Arnett, 1995).

Finally, children who are more aggressive themselves seem to prefer violent television. In one survey, parents who rated their children as aggressive also rated them as more interested in violent cartoons (Cantor & Nathanson, 1997). A similar pattern has been documented among adolescents (Selah-Shayovits, 2006). In a study of 8th graders, for example, boys who were rated as more aggressive by teachers also watched more violent films (Aluja-Fabregat, 2000). Huesmann, Moise-Titus, Podolski, and Eron (2003) have found longitudinal evidence showing that aggressive children seek out more violent television programs over time. Fenigstein (1979) and others (Cantor & Nathanson, 1997) speculate that aggressive people use violent scenes in the media to understand and justify their own



One final caveat concerns conceptual confusion about the term attraction. Several scholars have begun to recognize that there may be a distinction between being drawn to content that is violent, often called “selective exposure,” and actually enjoying that experience (Cantor, 1998; Weaver & Kobach, 2012). There seems to be growing empirical support for the idea that people may select violent over nonviolent material, but afterward they do not always like it better (Weaver & Kobach, 2012). In fact, Weaver (2011) recently separated the eight published studies that have assessed selective exposure to media violence from the 18 published studies that have looked at enjoyment after viewing screen violence. His meta-analysis (see definition of this term below) of these two groups of studies shows that violence affects selective exposure and liking in very different and opposite ways. That is, violence increases people’s desire to see a movie or TV show, but actually decreases their enjoyment after viewing. Clearly, unpacking these two concepts will help us to better understand the role that violence plays in media entertainment.

To summarize, there is a fair amount of evidence supporting the idea that violence sells. But a closer look at the data suggests that it is not that simple. For one thing, violence may be attractive to viewers because it is associated with action, suspense, or conflict. In this way, violence might serve as a proxy for other appealing plot features. It must be acknowledged, however, that nonviolent themes in programming can attract large audiences too. Nevertheless, the sheer prevalence of violence on television and in movies means that there are simply fewer options available if someone is seeking nonviolent content. Still, it may not be accurate to think of violence in a unidimensional way as either present or absent. Certain forms of violence seem to be more popular than others. In addition, particular individuals enjoy aggressive portrayals more than others do. To complicate matters further, Cantor (1998) speculates that there may be a relationship between an individual’s personality and the types of violence that are most appealing. For example, highly anxious children may seek out portrayals in which good wins over evil, whereas an aggressive bully may enjoy a good TV battle regardless of the characters involved or the outcome. In other words, more research is needed on the types of violent messages that are most appealing, on the types of youth who seek out this content, and on the distinction between selective exposure and enjoyment of violent entertainment.


Can Media Violence Lead to Aggression? Undoubtedly, the single issue that has received most attention with regard to the media is whether violent content can lead to aggressive behavior. No researcher today would argue that the media are the sole or even the most important cause of aggressive behavior in youth. Yet there is strong agreement among many social scientists that exposure to media violence can contribute to aggressiveness in individuals (see Bushman, Huesmann, & Whitaker, 2009; Comstock & Powers, 2012; Murray, 2008). This section will begin with an overview of the research evidence that has been brought to bear on this issue. Next we will present three theoretical perspectives that can help explain the relationship between media violence and aggression. The section will conclude with a discussion of who is most at risk for learning aggressive attitudes and behaviors from the media.

Experimental Studies Some of the earliest evidence linking media violence to aggression comes

from laboratory studies of children in controlled settings. In a series of classic experiments, Bandura and his colleagues exposed nursery school children to a filmed model who engaged in violent behaviors, often directed against a plastic, inflatable Bobo doll or punching bag (Bandura, Ross, & Ross, 1961, 1963a, 1963b). Afterward, children were taken to a playroom that contained a number of toys, including a Bobo doll, and their own behaviors were observed from behind a one-way mirror.

The purpose of such research was to investigate the circumstances under which children would learn and imitate novel aggressive acts they had seen on film. The researchers consistently found that children who were exposed to a violent model were more likely to act aggressively than were children in control groups who had not viewed such violence (Bandura et al., 1961, 1963b). Furthermore, children were more likely to imitate a violent model who had been rewarded with cookies than one who had been punished. In fact, children generally imitated the model so long as no punishment occurred, suggesting that the absence of punishment can serve as a tacit reward or sanction for such behavior (Bandura, 1965).

Bandura and his colleagues also found that children could learn novel aggressive responses as easily from a cartoonlike figure, a “Cat Lady,” for example, as from a human adult (Bandura et al., 1963a). This finding clearly


implicates Saturday morning TV as an unhealthy reservoir of violence. Subsequent studies using similar procedures revealed other aspects of imitation. For example, children exposed to televised aggressive sequences could reproduce the behaviors they had seen up to six to eight months later (Hicks, 1965). In addition, preschoolers would aggress against a human adult dressed as a clown just as readily as they would a Bobo doll (Hanratty, O’Neal, & Sulzer, 1972; Savitsky, Rogers, Izard, & Liebert, 1971). This finding helped to undercut the criticism that attacking an inflatable doll is merely play behavior and not akin to real aggression.

Experimental studies have looked at older age groups, too. For instance, research shows that older adolescents and even adults who are exposed to television violence in laboratory settings will engage in increased aggression (Coyne et al., 2008; Scharrer, 2005).

However, the experimental evidence has been criticized on methodological grounds (Fowles, 1999; Freedman, 2002). Laboratory studies often (a) employ unrealistic or “play” measures of aggression, (b) are conducted in artificial viewing situations, (c) involve adult experimenters who willingly show violence on TV in a way that may seem to be condoning aggression, and (d) are able to assess only short-term effects of exposure. According to Fowles (1999), “Viewing in the laboratory setting is involuntary, public, choiceless, intense, uncomfortable, and single-minded. . . . Laboratory research has taken the viewing experience and turned it inside out so that the viewer is no longer in charge” (p. 27).

To overcome some of these limitations, researchers have conducted field experiments in nonlaboratory settings with more realistic measures of aggression (Friedrich & Stein, 1973; Josephson, 1987). For example, in one early study, 3- to 5-year-old children were randomly assigned to watch violent or nonviolent TV shows for 11 days at their school (Steuer, Applefield, & Smith, 1971). Children in the violent viewing condition displayed significantly more physical aggression against their peers (e.g., hitting, kicking, throwing objects) during play periods than children in the nonviolent TV group did.

In a study 20 years later, researchers exposed elementary schoolers to a single episode of the Mighty Morphin Power Rangers and then observed verbal and physical aggression in the classroom (Boyatzis, Matillo, & Nesbitt, 1995). Compared with a control group, children and particularly boys who had watched the violent TV program committed significantly


more intentional acts of aggression inside the classroom, such as hitting, kicking, shoving, and insulting a peer. In fact, for every aggressive act perpetrated by children in the control group, there were seven aggressive acts committed by children who had seen the Power Rangers. Notably, these types of bullying behaviors are no longer seen as part of normal development and have been linked to high levels of psychological distress, poor social and emotional adjustment, failure in school, and even long-term health difficulties among victims (Nansel et al., 2001; Rigby, 2003).

With regard to the Power Rangers, the Boyatzis and colleagues (1995) study reveals that the prosocial message delivered at the end of each episode in this TV series is not nearly as salient to children as the perpetual violence that the superheroes commit (see Figure 4.5). At least one other study has demonstrated that moral lessons on television are relatively ineffective when they are couched in violence (Liss, Reinhardt, & Fredriksen, 1983).

In general, controlled experiments dating back to the 1960s clearly demonstrate that exposure to screen violence can cause some children to behave aggressively immediately after viewing (for a review, see Huesmann, 2007). Moreover, this effect has been found with various age groups and in laboratory as well as more naturalistic studies. But such evidence is still limited in that it points only to immediate effects that may not persist much beyond the viewing situation. In addition, most experiments involve small samples of children or teens who may or may not be representative of young people in general.

Correlational Studies In the 1970s, a number of investigators surveyed large populations of

children and teenagers to determine if those who were heavy viewers of TV violence were also more aggressive. As an example, one study surveyed 2,300 junior and senior high school students in Maryland and asked them to list their four favorite programs, which were then analyzed for violent content (McIntyre & Teevan, 1972). Measures of aggression were compiled from a self-reported checklist of activities, using five scales that ranged from aggressive acts (e.g., fighting at school) to serious delinquency (involvement with the law). Results revealed that children whose favorite programs were more violent were also higher in overall aggressive and delinquent behavior.


Figure 4.5 Examples of superheroes who often commit violence for prosocial reasons.

Other studies used slightly different measures of aggression, including peer ratings (McLeod, Atkin, & Chaffee, 1972a, 1972b) and self-reports of willingness to use violence in hypothetical situations (Dominick & Greenberg, 1972). Across different samples in different regions of the United States, the findings were remarkably consistent. Higher exposure to TV violence was positively associated with higher levels of aggressive behavior (Belson, 1978; Dominick & Greenberg, 1972; McLeod et al., 1972a, 1972b; Robinson & Bachman, 1972). Furthermore, the relationship held up even after controlling for factors such as parental education, school achievement, socioeconomic status, and overall amount of television viewing (McLeod et al., 1972a, 1972b; Robinson & Bachman, 1972).

The relationship between TV violence and aggressive behavior has been documented in other nations as well. In a survey of more than 30,000 adolescents from eight different countries (Kuntsche et al., 2006), heavy television viewing was significantly associated with increased verbal aggression and verbal bullying. This finding held up in all eight countries, even after controlling for gender and age. In three of the countries in which teens spent a lot of time watching TV on weekends (i.e., the United States,


Poland, Portugal), there was also a significant relationship between television viewing and physical forms of bullying (e.g., kicking, pushing).

More recently, Ybarra and her colleagues (2008) found that exposure to violence on the Internet is associated with youth aggression. The researchers randomly sampled over 1,500 American 10- to 15-year-olds and used an online survey to ask them about their media exposure, their home situation, their peer group, and their own violent behavior (defined in this case as aggravated assault, robbery, sexual assault, or stabbing or shooting someone). Those who indicated that many, most, or all of the websites they visited depicted real people engaging in violence were five times more likely to report engaging in seriously violent behavior than were those who never visited such sites. This relationship held up even after controlling for household income, alcohol use, trait aggression, having delinquent friends, and exposure to violence in the community. The websites defined as violent in this study included hate sites, sites showing satanic rituals, sites depicting war or terrorism, and sites showing dead people or people dying. The large and often representative samples in these studies suggest that the causal effects documented in experimental studies can be generalized to the real world. However, the problem with correlational studies is that we cannot be certain about which variable came first. Screen violence could be causing an increase in aggression. Alternatively, youth who are already aggressive could be seeking out violent content. To disentangle the direction of causality, longitudinal studies are needed.

Longitudinal Studies In the past several decades, social scientists have increasingly moved

toward longitudinal studies, which involve surveying the same group of individuals at repeated intervals over time. This type of design permits a researcher to test the cumulative effects of exposure to the media. It also provides a test of the “chicken and egg” quandary: Does violence in the media lead to aggression, or do aggressive people seek out such content?

In one of the most impressive longitudinal studies, Leonard Eron, Rowell Huesmann, and their colleagues tested the same sample of children, originally from upstate New York, over a 22-year period (Eron, Huesmann, Lefkowitz, & Walder, 1972; Huesmann, 1986; Huesmann, Eron, Lefkowitz, & Walder, 1984; Lefkowitz, Eron, Walder, & Huesmann, 1972). The researchers measured television viewing habits and aggressive behavior at three different points in time: when the participants were 8, 19, and 30 years


of age. As seen in Figure 4.6, the results revealed that among boys, the relationship between viewing TV violence in the 3rd grade and aggressive behavior 10 years later was positive and highly significant. In other words, exposure to TV violence during early childhood was predictive of higher levels of aggression at age 19. This relationship persisted even after controlling for IQ, socioeconomic status (SES), and overall exposure to television. In contrast, aggressive behavior in the 3rd grade was not predictive of violent TV consumption at age 19. Thus, the idea that being aggressive can lead a child to watch more TV violence did not receive support. Interestingly, neither of the cross-lagged correlations from Time 1 to Time 2 was significant for girls.

The researchers followed up on these same individuals another 10 years later, most of them now age 30 (Huesmann, 1986). In some of the most compelling evidence to date, the data revealed a link between exposure to TV violence at age 8 and self-reported aggression at age 30 among males (Huesmann & Miller, 1994). Moreover, violent TV habits in childhood were a significant predictor of the seriousness of criminal acts performed at age 30 (see Figure 4.7). Once again, this relationship held up even when childhood aggression, IQ, SES, and several parenting variables were controlled. Huesmann (1986) concluded that “early childhood television habits are correlated with adult criminality independent of other likely causal factors” (p. 139).

Using a similar longitudinal approach, these same researchers conducted a three-year study of more than 1,000 children in five countries: Australia, Finland, Israel, Poland, and the United States (Huesmann & Eron, 1986a). Despite very different crime rates and television programming in these nations, early childhood exposure to television violence significantly predicted subsequent aggression in every country except Australia. Furthermore, the relationship was found just as often for girls as for boys in three of the countries, including the United States. Finally, although the relationship between early TV habits and later aggression was always stronger, there was some evidence for the reverse direction: Early aggression led to higher levels of violent viewing. Based on this pattern, Huesmann and his colleagues argued that pinning down the precise direction of causality between TV violence and aggression is not so crucial because the relationship is probably reciprocal: Early violent viewing stimulates aggression, and behaving aggressively then leads to a heightened interest in violent TV content (Huesmann, Lagerspetz, & Eron, 1984). Likewise, Slater (2003) has posited that the relationship between TV violence and


aggressive behavior becomes mutually reinforcing over time, resulting in what he calls a “downward spiral model.”

Figure 4.6 TV violence watched in 3rd grade correlates with aggressive behavior at age 19 for boys.

SOURCE: Reproduced from Liebert and Sprafkin (1988).

Figure 4.7 The relationship between boys’ viewing of TV violence at age 8 and their violent criminal behavior 22 years later.

SOURCE: Adapted from Huesmann (1986).

The most recent longitudinal research by Huesmann and his colleagues continues to support the idea that both boys and girls are influenced by


television violence (Huesmann et al., 2003). In this study, the researchers interviewed more than 500 elementary school children and then surveyed them again 15 years later. Again, they found that heavy exposure to television violence in childhood predicted increased aggressive behavior in adulthood. Unlike their earliest work, their more current evidence reveals the same pattern for both boys and girls. The researchers have speculated that the shift in findings pertaining to girls is due to increased societal acceptance of assertive behavior for females as well as an increase in aggressive female characters on television.

With one exception (Milavsky, Kessler, Stipp, & Rubens, 1982), other longitudinal evidence corroborates these patterns. For example, in one 5- year study, children who had watched the most television during preschool, particularly action adventure shows, were also the most aggressive at age 9 (Singer, Singer, & Rapaczynski, 1984). Early viewing of violence in the preschool years also predicted more behavioral problems in school. These relationships remained just as strong after the effects of parenting style, IQ, and initial aggressiveness were statistically removed. More recently, a large-scale longitudinal study of German teens found the same over-time connection between early exposure to violent screen media and aggressive behavior one year later (Krahe & Moller, 2010), even after controlling for preexisting trait aggression, academic achievement, and nonviolent media use.

To summarize, longitudinal studies provide powerful evidence that television violence can have a cumulative effect on aggression over time. Childhood exposure to such content has been shown to predict aggression in later years and even serious forms of criminal behavior in adulthood. Some of the earliest research indicated that these effects held true only for boys, but more recent studies have found significant relationships over time for girls too. Finally, the relationship between TV violence and aggressive behavior may be cyclical in nature, such that each reinforces and encourages more of the other.

Meta-analyses When researchers conclude that media violence can increase aggressive

attitudes and behaviors, they typically look at all the evidence collectively. Lab experiments provide convincing evidence of causal effects, but they may be detecting outcomes that would not occur in everyday life, and they assess short-term effects only. Field experiments increase our confidence


that real aggression is involved; correlational studies show that there is a positive relationship between TV violence and aggression in large, often representative samples of youth; and longitudinal studies suggest a cumulative effect of TV violence over time, even after controlling for other potential causal variables. In other words, each method has its strengths and weaknesses, but collectively the research shows a consistent pattern.

Another way to detect patterns is to conduct a meta-analysis. A meta- analysis is the statistical analysis of a large collection of results from individual studies. In this case, each study becomes a data point in a new, combined “super-study” (Mullen, 1989). The goal of a meta-analysis is to synthesize findings from a large body of studies but to do so in a statistical rather than a descriptive way (Cooper & Hedges, 1994). Meta-analyses produce numerical estimates of the size of an effect across all studies on a particular topic.

Several meta-analyses have been conducted on the research regarding media violence and aggression. In the earliest one, Hearold (1986) looked at 230 studies of the impact of TV on both prosocial and antisocial behavior. Antisocial behavior consisted mostly of physical aggression but also included other outcomes such as theft and rule breaking. Hearold found an average effect size of 0.30 (similar to a correlation) between violent TV content and the broad category of antisocial behavior. According to scientific conventions, any effect around 0.1 is considered to be “small,” around 0.3 to be “medium,” and around 0.5 to be “large” (Cohen, 1988).

In a much smaller meta-analysis, Christensen and Wood (2007) examined only those experiments that observed children’s aggressive behavior in unconstrained situations, after viewing violence. The goal was to isolate the studies that used realistic settings and realistic measures of aggression in order to respond to the criticism that laboratory studies are artificial. Across a total of 29 experiments, the researchers found a significant aggregate effect of media violence on aggression. They concluded that “media violence enhances children’s and adolescents’ aggression in interactions with strangers, classmates, and friends” (p. 164).

Updating the Hearold (1986) study, Paik and Comstock (1994) analyzed 217 studies of the impact of television violence on antisocial behavior (the researchers did not include studies of prosocial behavior, as Hearold did). Paik and Comstock found that the overall effect size between TV violence and antisocial behavior was 0.31, surprisingly consistent with that found by Hearold. Another way to interpret this statistic is that roughly 10% of the


individual variation (0.312) in antisocial behavior can be accounted for by exposure to TV violence.

More recently, Bushman and Anderson (2001) limited their meta-analysis to studies looking at aggression as an outcome rather than the broader category of antisocial behavior. Across 212 different samples, the researchers found a positive and significant relationship between media violence and aggression. In addition, the study found that since 1975, the effect sizes in media violence research have increased in magnitude, suggesting that the media are becoming more violent and/or that people are consuming more of this type of content.

Bushman and Anderson (2001) also compared the overall effect of media violence with other types of effects found in scientific research. As it turns out, the link between media violence and aggression is much stronger than several effects that today go unquestioned, such as the link between ingesting calcium and increased bone mass or the link between exposure to asbestos and laryngeal cancer (see Figure 4.8). Furthermore, the correlation between media violence and aggression (0.31) is only slightly smaller than that between smoking and lung cancer (nearly 0.40). Obviously, not everyone who smokes will develop lung cancer, but the risk is real and significant. The analogy to media violence is clear; not every child or teen who watches a heavy dose of violent programming will become aggressive, but some young people are certainly at risk of doing so.

Figure 4.8 A comparison of the media violence-aggression link with other public health relationships that have been established scientifically.


SOURCE: Adapted from Bushman and Huesmann (2001).

Despite these large-scale meta-analyses, there are still a few researchers who raise doubts about the evidence. Gunter (2008) offers an in-depth critique of the shortcomings of the research, including the fact that effect sizes are small, and cautions against accepting “blanket conclusions about harmful effect of media violence” (p. 1061). Instead, he calls for a more refined approach that focuses on the types of people who are most at risk for harmful effects and the types of media depictions that are most problematic. Even more critical, Ferguson and Kilburn (2009, 2010) have conducted their own meta-analyses and argue that once unpublished studies and studies with poor measures of aggression are removed, there is little evidence that media violence increases aggressive behavior. Ferguson and Kilburn’s work has been criticized vigorously by some of the most renowned media scholars in the field (Bushman, Rothstein, & Anderson, 2010; Huesmann, 2010). The debate, published in the journal Psychological Bulletin, illustrates how complex the issues are and how heated the topic can get, even in the academic community. Still, after reviewing the accumulated evidence from the last 50 years, the majority of media effects researchers and the major health-related professional associations in the United States (e.g., American Medical Association, American Psychological Association, American Academy of Pediatrics) assert that exposure to screen violence increases the risk of aggressive behavior among youth.

Why Does Exposure to Violence Encourage 240

Aggression? Many theories have been offered to account for the relationship between media violence and aggression. Catharsis theory was first proposed by Aristotle, who argued that good drama offers audience members a way to purge their negative feelings of emotion. Extended to media violence, the idea is that exposure to such content can cleanse one’s feelings of anger and frustration, resulting in a therapeutic reduction in aggression. There is very little empirical support for catharsis theory. In fact, most data suggest an opposite, instigational effect of media violence on aggression (see Huesmann, Dubow, & Yang, 2013). Yet catharsis theory continues to be cited today, especially by some members of the media industry. Another theory called excitation transfer posits that any type of media content can enhance aggression so long as the material is arousing (Zillmann, 1991). According to excitation transfer theory, an erotic film is more likely to enhance aggression in an angered individual than a violent film is, so long as the erotic material is more arousing (Zillmann, 1971).

In this section, we will review three major perspectives, all of which focus on the content of media portrayals rather than their arousal properties. Each perspective has generated much research and made significant contributions to our understanding of how media violence might facilitate aggression.

Cognitive Priming Cognitive priming is a perspective developed by Berkowitz and his

colleagues to explain short-term reactions to media violence (Berkowitz, 1984; Jo & Berkowitz, 1994). According to the theory, violent stimuli in the media can activate or elicit aggressive thoughts in a viewer. These thoughts can then “prime” other closely related thoughts, feelings, and even motor tendencies stored in memory. For a short time after exposure, then, a person is in a state of activation whereby hostile thoughts and action tendencies are at the forefront of the mind. Research supports the idea that violent media content can “prime” aggressive thoughts in people (Bushman & Geen, 1990). For example, in a study by Berkowitz, Parker, and West (cited in Berkowitz, 1973, pp. 125–126), children who read a war comic book were more likely to select aggressive words when asked to complete a series of sentences than were children who read a neutral comic book.


Several conditions can encourage these aggressive thoughts and feelings to unfold into aggressive behavior. One such condition is the person’s emotional state. Berkowitz (1990) argued that individuals who are experiencing a negative affect, particularly anger or frustration, are more likely to be primed to act aggressively by the media because they are in a state of readiness to respond in a fight-or-flight manner. Indeed, angered individuals do seem to be more strongly influenced by media violence (Paik & Comstock, 1994).

Another condition that helps encourage individuals to act out their aggressive thoughts is justification (Jo & Berkowitz, 1994). If media violence is portrayed as morally proper, it can help to reduce a person’s inhibitions against aggression for a short time afterward, making it easier to act out such behavior. Justified violence in the media may even help a person rationalize her or his own aggression (Jo & Berkowitz, 1994). There is a great deal of evidence indicating that justified violence can facilitate aggression (Paik & Comstock, 1994).

Finally, cues in the environment that remind people of the media violence they have just seen can trigger aggressive behavior (Jo & Berkowitz, 1994). Such cues help to reactivate and sustain the previously primed aggressive thoughts and tendencies, thereby prolonging the influence of the violent media content. In a classic study that demonstrates such cuing, 2nd- and 3rd- grade boys were exposed to either a violent or a nonviolent TV show (Josephson, 1987). The violent program prominently featured walkie-talkies in the plot. Immediately afterward, the boys were taken to a school gymnasium to play a game of floor hockey. At the start of the game, an adult referee interviewed each boy using a walkie-talkie or a microphone. Results revealed that aggression-prone boys who had viewed the violent program and then saw the real walkie-talkie were more aggressive during the hockey game than were those in any other condition, including boys who had seen the violent show but no real walkie-talkie. According to priming theory, the walkie-talkie served as a cue to reactivate aggressive thoughts and ideas that had been primed by the earlier violent program.

A recent meta-analysis by Roskos-Ewoldsen, Klinger, and Roskos- Ewoldsen (2007) demonstrated that exposure to violent media images and even violence-related concepts such as weapons can prime aggressive thoughts and behaviors. Primes that are intense or repeated have the strongest effects, as do primes that have recently occurred (Roskos- Ewoldsen, Roskos-Ewoldsen, & Carpentier, 2009). The research also


suggests that the effects of a prime will fade over time (see Roskos- Ewoldsen et al., 2009).

Cognitive priming theory helps to explain how media violence can have short-term effects by triggering already learned aggressive thoughts and behaviors. But where do these aggressive tendencies come from originally? Social learning theory focuses on how the media can help children acquire aggressive attitudes and behaviors in the first place.

Social Learning Developed by Bandura (1965), social learning theory posits that children

can learn new behaviors in one of two ways: by direct experience through trial and error, or by observing and imitating others in their social environment. Bandura (2009) has pointed out that observational learning is ultimately more efficient than trying to discover everything on your own. Children can and do learn from other people in their environment, including parents, siblings, peers, and teachers. Children can also learn from characters and people featured in the media (see Figure 4.9).

According to social learning theory, a child observes a model enact a behavior and also witnesses the reinforcements that the model receives. In a sense, the child experiences those reinforcements vicariously. If the model is rewarded, the child too feels reinforced and will imitate or perform the same behavior. If the model is punished, the child is unlikely to perform the behavior, although the actions may still be stored in memory and performed at a later date (Bandura, 1965).

Early experiments supported social learning theory and demonstrated that children could learn just as easily from a filmed model as from a real person (Bandura, 1965; Bandura et al., 1963a, 1963b; Walters & Parke, 1964). In addition to imitation, early research showed that the media could encourage children to act aggressively in ways that differed from the precise behaviors seen in a portrayal. In one study, nursery school children viewed either a violent or a nonviolent cartoon and then were given two toys to play with (Lovaas, 1961). One toy had a lever that caused a doll to hit another doll over the head with a stick; the other toy consisted of a wooden ball that maneuvered through obstacles inside a cage. Compared with those in the nonviolent condition, children who had seen the violent cartoon used the hitting doll more frequently. Bandura and his colleagues (1963b) called this process “disinhibition,” whereby exposure to media violence can weaken a


child’s normal inhibitions or restraints against behaving aggressively, resulting in acts of violence that are similar but not identical to what was seen in a program. More recently, Bandura (2009) has labeled this process “abstract modeling” because an observer extracts a general rule or concept from watching a specific modeled action and then generates a new behavior that goes beyond what was observed.

Figure 4.9

SOURCE: New Breed © 1991 Bob Ting. Dist. by King Features Syndicate.

Today, certain models in the media can have remarkable effects on young people. Consider the thousands of preteen and teen girls who donned chains and skimpy clothes in an effort to emulate Madonna during her Material Girl phase. More recently, Miley Cyrus, Selena Gomez, and Justin Bieber are some of the stars that seem to be captivating American youth. One survey of Los Angeles teens found that nearly 40% of the 12- to 17-year-olds named a media figure as their role model—roughly the same percentage (42%) that named a parent or relative (Yancey, Siegel, & McDaniel, 2002). As a well- known Hollywood producer once stated,

I’d be lying if I said that people don’t imitate what they see on the screen. I would be a moron to say they don’t, because look how dress styles change. We have people who want to look like Julia Roberts and Michelle Pfeiffer and Madonna. Of course we imitate. It would be impossible for me to think they would imitate our dress, our music, our look, but not imitate any of our


violence or our other actions. (quoted in Auletta, 1993, p. 45)

In the 1980s, Bandura (1986) reformulated his theory because it had been criticized as too behavioristic, focusing mostly on reinforcements and how people act. Now called social cognitive theory, the newer perspective acknowledges that cognitive processes such as attention and retention are involved in observational learning (Bandura, 2009). These mental activities place more emphasis on how children symbolically construe or make sense of a model’s behavior. Children selectively pay attention to different features of a model’s behavior, they bring forth different experiences to interpret and evaluate the model’s actions, and they store different information in memory. These types of cognitive processes can be used to help explain why some children might imitate a model but others do not.

Social learning and social cognitive theory are useful frameworks for understanding how children can learn new behaviors from media violence. But they tend to focus most on short-term learning. The final theory we will discuss takes observational learning a bit further and provides a perspective to account for cumulative or long-term effects of media violence on a child’s behavior.

Social Informational Processing Theory Huesmann (1998) proposed an information processing model that deals

with how aggressive behaviors are both developed and maintained over time. The model focuses on scripts, which are mental routines for familiar events that are stored in memory (Abelson, 1976). A script typically includes information about what events are likely to happen, how a person should behave in response to these events, and what the likely outcome of these behaviors will be. Consequently, scripts are used to guide behavior and social problem solving. For example, young children possess scripts for common activities such as going to the doctor and getting ready for bed.

Scripts can be acquired through personal experience as well as through exposure to the media (Krcmar & Hight, 2007). Huesmann (1998) has argued that a child’s early learning experiences play a critical role in the development of scripts. According to the theory, a child who is exposed to a great deal of violence, either in real life or through the media, is likely to develop scripts that encourage aggression as a way of dealing with problems (Huesmann, 1988).

Once scripts are learned, they can be retrieved from memory and tried out


in social situations (see Figure 4.10). Some scripts are easier to retrieve than others. Those that are rehearsed by the child, through simple recall, through fantasizing, or even through playacting, will be more accessible in memory. In addition, cues in the environment that are similar to those present when the script was first developed can encourage retrieval of that script (Tulving & Thomson, 1973). Similar to priming, then, a situational cue can prompt an aggressive memory based on a previously seen violent TV show or film.

Regardless of how a script is retrieved, once an aggressive strategy is employed, it can be reinforced and elaborated by new information in a given situation, and eventually the script becomes applicable to a wider set of circumstances (Geen, 1994). According to this perspective, the aggressive child is one who has developed from an early age a network of stable and enduring cognitive scripts that emphasize aggression as a response to social situations. Consistent and repeated exposure to violent messages in the media can contribute to the creation of these scripts and to the retrieval of already learned ones (Krcmar & Hight, 2007).

Huesmann’s theory incorporates ideas from observational learning and from priming but takes a broader view of how the media can contribute to aggression over time. This perspective reminds us that media violence is only one of many environmental influences that can foster habitual forms of aggression in some children. Yet according to a U.S. surgeon general’s report, media violence is as great a risk factor as other commonly known predictors of youth violence, such as low IQ, hyperactivity, poor parenting, and lack of social ties (U.S. Department of Health and Human Services, 2001). Next, we turn to the types of media portrayals that are most likely to teach aggressive patterns of behavior and the types of individuals who are most at risk for this learning.

Figure 4.10 Use of scripts in social situations.


Types of Portrayals That Encourage the Learning of Aggression As discussed earlier, violence can be portrayed in a variety of ways. For instance, the same act of aggression looks very different when it is perpetrated by a law officer trying to save lives than by a thief trying to steal something. As it turns out, the way in which violence is portrayed may be even more important than the sheer amount of it when trying to assess its likely impact on a viewer. Research has identified seven contextual features of violence that affect the likelihood that a viewer will learn aggressive attitudes and behaviors from a portrayal (see Wilson et al., 1997).

First, an attractive perpetrator increases the risk of learning aggression. In accordance with social learning theory, children as well as adults are


more likely to attend to, identify with, and learn from attractive role models than they are unattractive ones (Bandura, 1986, 2009). The most obvious way to make a perpetrator appealing is to make her or him a hero (Calvert, Murray, & Conger, 2004; Liss et al., 1983). But even characters who act in benevolent ways can be attractive to young people (Hoffner & Cantor, 1985). Moreover, characters who are similar to the self can be potent role models. Research suggests that children, for example, pay more attention to younger than older characters when watching television (Schmitt, Anderson, & Collins, 1999) and are more likely to imitate peer models than they are adult models (Hicks, 1965). Viewers also pay attention to and identify more with same-sex characters than opposite-sex ones (Hoffner & Buchanan, 2005; Jose & Brewer, 1984).

Second, the motive or reason for violence is important. Consistent with cognitive priming, violent actions that seem justified or morally defensible can facilitate viewer aggression, whereas unjustified violence can actually diminish the risk of learning aggression (Berkowitz & Powers, 1979; Hogben, 1998). Third, the presence of weapons in a portrayal, particularly conventional weapons such as guns and knives, can enhance aggressive responding among viewers (Berkowitz, 1990; Carlson, Marcus-Newhall, & Miller, 1990). Weapons are assumed to function as a violent cue that can prime aggressive thoughts in a viewer (Subra, Muller, Begue, Bushman, & Delmas, 2010).

Fourth, violence that seems realistic can promote greater learning of aggressive attitudes and behaviors among viewers (Atkin, 1983; Krcmar, Farrar, & McGloin, 2011). From this finding, it is tempting to conclude that cartoon or fantasy violence in the media is relatively harmless. However, research with very young children, to be discussed below, challenges such an assumption.

Fifth, we know from social learning theory that violence that is explicitly rewarded or that simply goes unpunished increases the risk of imitative aggression, whereas violence that is condemned decreases that risk (Bandura, 1965; Carnagey & Anderson, 2005). Sixth, the consequences of violence for the victim are an important contextual cue; explicit portrayals of a victim’s physical injury and pain can actually decrease or inhibit the learning of aggression among viewers (Baron, 1971a, 1971b; Wotring & Greenberg, 1973). Finally, violence that is portrayed as humorous can increase aggression in viewers (Baron, 1978; Berkowitz, 1970). Part of the reason for this effect is that humor can trivialize the seriousness of violence


(Gunter & Furnham, 1984). Researchers have speculated that humor may also serve as a positive reinforcement or reward for violence (Berkowitz, 1970).

Taken as a whole, the research clearly suggests that there are risky and not-so-risky ways of portraying violence. If a parent is concerned about a child learning aggressive behaviors from the media, then programs that feature heroes or good characters engaging in justified violence that is not punished and results in minimal consequences should be avoided (see Table 4.2). As it turns out, this formula is very common in animated programming, especially superhero and slapstick cartoons (Wilson, Smith, et al., 2002). On the other hand, portrayals that feature less attractive perpetrators who are punished in the plot and whose violence results in serious negative consequences can actually teach youth that aggression is not necessarily a good way to solve problems.

Types of Youth Most at Risk Not only do certain messages pose more risk, but certain young people are more susceptible to violent content. In their meta-analysis, Paik and Comstock (1994) found that viewers of all age groups can be influenced by television violence but that preschoolers showed the strongest effect size. This is consistent with Huesmann’s (1998) argument that early childhood learning is critical. It also reflects the fact that younger children are least likely to have developed and internalized strong social norms against aggression. Younger children also have difficulty distinguishing reality from fantasy on television (see Chapter 1 and discussion below), making them prone to imitating even the most fantastic presentations.

Table 4.2 Risky Versus Educational Depictions of Violence


The heightened vulnerability that characterizes the preschool years means that parents should be especially cautious about mindlessly using television as a babysitter for their young children. Indeed, studies indicate that babies as young as 18 months old are capable of imitating and remembering what they see on television (Brito, Barr, McIntyre, & Simcock, 2012). Fortunately, when busy parents need a break, public broadcast channels contain very little violence and feature educational programs such as Sesame Street that are truly enriching for children (Fisch & Truglio, 2001).

Research also indicates that at any age, children who perceive television as realistic and who identify strongly with violent characters are most likely to learn from violent content (Huesmann et al., 2003; Konijn, Nije Bijvank, & Bushman, 2007). In a tragic case in 1999, a 12-year-old fan of TV wrestling claimed he was simply imitating his favorite heroes when he threw a 6-year-old playmate into a metal staircase, killing her (see box below). It seems that even some older children can be confused by highly scripted and unrealistic portrayals of violence.

Being in a particular emotional state can also make a child more vulnerable. Numerous studies reveal that viewers who are made to feel angry or frustrated are more likely to behave aggressively after exposure to media violence than nonangered persons are (see Paik & Comstock, 1994). According to priming theory, angered individuals are in a state of readiness to respond that facilitates aggressive actions (Berkowitz, 1990). It is important to note, however, that a child does not have to be angry to learn


aggression from the media (see Hearold, 1986).

Being unpopular with peers and doing poorly in school also place a child at greater risk for learning aggression from media violence (see Huesmann, 1986). Social and academic failures can be frustrating experiences that instigate aggression (Huesmann, 1988). Such experiences in turn can lead to more social withdrawal and more television viewing, making the process a vicious cycle. Finally, children raised in homes characterized by parental rejection and parental aggression show stronger effects of media violence (Bauer et al., 2006; Singer & Singer, 1986).


Lionel Tate at age 14

On July 28, 1999, a 12-year-old boy named Lionel Tate beat to death his 6-year-old playmate, Tiffany Eunick. The two were playing in the Florida home that Lionel shared with his mother, who was babysitting the girl. The mother was asleep at the time.

An autopsy showed that Tiffany had suffered a fractured skull, lacerated liver, internal hemorrhaging, and more than 30 other injuries. The 170-pound boy allegedly had punched, kicked, and thrown the 48- pound girl around the room. When questioned by authorities, Lionel claimed to have accidentally thrown Tiffany into a metal staircase and a wall while trying to toss her onto a sofa.

During the murder trial, defense attorney Jim Lewis argued that Lionel was an avid fan of pro wrestling who was imitating moves he had seen on TV without realizing the damage that could occur. He claimed that Lionel was too immature to understand that pro wrestlers are not actually hurting one another. “He wanted to emulate them,” attorney Jim Lewis said (Spencer, 2001). “Like Batman and Superman, they were his heroes. He loved to play.” Earlier, Lewis had tried unsuccessfully to subpoena professional wrestlers to testify at the trial.


Lionel Tate at 14.

Prosecutor Ken Padowitz argued that television violence was not on trial and that the boy knew he was savagely beating Tiffany.

After only three hours of deliberation, a Florida jury found Lionel guilty of first-degree murder. Pointing to the cruelty and callousness of Lionel’s acts, Judge Joel T. Lazarus sentenced the boy to life in prison without the possibility of parole. Tate was one of the youngest defendants in the United States to be sentenced to spend the rest of his life in prison.

In 2004, a state appeals court overturned Tate’s conviction. The appeals court ruled that it was not clear whether Tate had understood the charges against him. He was freed from prison after he agreed to plead guilty to second-degree murder and was sentenced to time already served and 10 years’ probation.

Tate has been in and out of court since then. In 2005, he was arrested and accused of robbing a pizza delivery person at gunpoint. In 2006, he pled guilty to gun possession, which violated his probation, and is now serving 30-year prison sentence. In 2008, he pled no contest to the robbery charge and was sentenced to 10 years, to be served concurrently with his 30-year sentence.

It is important to remember that no single factor will propel a child from nonviolence to violence. Instead, each risk factor increases the chances that a child will internalize and act out the violence that she or he witnesses in the media. Huesmann and Eron (1986b) summarize risk in the following way: “For most children, aggressiveness seems to be determined mostly by the extent to which their environment reinforces aggression, provides


aggressive role models, frustrates and victimizes the child, and instigates aggression” (p. 4).

Developmental Differences in Processing Media Violence Chapter 1 describes several ways in which younger and older children differ in their processing of media messages. At least three of these have important implications for how young people are likely to interpret media violence. First, children differ markedly in their cognitive ability to distinguish reality from fantasy (see Dorr, 1983; Wright, Huston, Reitz, & Piemyat, 1994). Preschoolers often assume that anything that looks or sounds real is real (Brown, Skeen, & Osborn, 1979). Consistent with this tendency, studies show that preschoolers and even young elementary schoolers will readily imitate violent cartoon characters such as the ThunderCats and even Bugs Bunny (Bandura et al., 1963a; Friedrich & Stein, 1973; Steuer et al., 1971). Such portrayals are likely to be discounted as fantasy by older, more sophisticated viewers who are far more responsive to portrayals of violence involving events and characters that are possible in the real world (Atkin, 1983; Scharrer, 2005; Thomas & Tell, 1974).

The television rating system takes this developmental consideration into account with its “TVY7” label. Programs rated TVY7 are designed for children 7 years of age and older who have “acquired the developmental skills needed to distinguish between make-believe and reality” (TV Parental Guidelines, n.d.).

A second relevant cognitive skill concerns the shift from perceptual to conceptual processing (Fisher, 2011). Younger children pay close attention to perceptually salient features in a program, such as what characters look like and what they do (Gibbons, Anderson, Smith, Field, & Fischer, 1986; Hoffner & Cantor, 1985; van den Broek, Lorch, & Thurlow, 1996). Older children and teens, on the other hand, can consider more conceptual or abstract information in a plot (Collins, 1975; van den Broek et al., 1996). In the realm of violence, this means that younger children are most likely to comprehend and learn from those violent behaviors and consequences that are explicitly portrayed on screen in concrete ways. When events are implied or not visually depicted, they will be more difficult for a young


child to discern. In support of this idea, Krcmar and Cooke (2001) found that younger children focused more on the punishments that a character received in judging whether an aggressive behavior was right or wrong, whereas older children focused more on the character’s motives, which are typically depicted in more subtle ways.

A third important skill is the ability to draw inferences. As seen in Chapter 1, younger children are less able than their older counterparts to link scenes together, integrate information, and draw causal conclusions from the plot (Kendeou, Bohn-Gettler, White & van den Broek, 2008). Therefore, contextual cues that are separated from the violence itself will be more difficult for younger children to appreciate. Collins (1973) demonstrated this in an intriguing study involving 3rd, 6th, and 10th graders. Children viewed a violent scene in which the perpetrator was punished either immediately after engaging in violence or after a four-minute commercial break. The results revealed that 3rd graders gave more aggressive responses themselves in the separation than in the no-separation condition (see Figure 4.11). In other words, the commercial break interfered with younger children’s ability to connect the punishment to the violence— the violence stood alone as a model for behavior. In contrast, older children’s responses were unaffected by the separation manipulation, suggesting that they appreciated the punishment even when it occurred at a different point in the storyline.

Unfortunately, television supplies numerous instances in which aggressive behavior goes unpunished, at least in the short run; if punishment is delivered, it typically happens toward the end of the plot (Wilson, Smith, et al., 2002). A child younger than age 7 or 8 is not capable of connecting this delayed consequence back to an earlier transgression. Therefore, if punishment is temporally separated from the act, it will seem to a younger viewer as if the perpetrator “got away” with violence.

Figure 4.11 Aggression scores as a function of whether the punishment was separated from a violent act by a four-minute commercial.


SOURCE: Adapted from Collins (1973).

Young children are also likely to have trouble deducing or inferring the moral of a televised story (Mares &Acosta, 2008). Moreover, their grasp of a moral lesson may be particularly challenging if there are negative emotions portrayed in the plot, which is often the case with media violence. Hence, even if a movie concludes with an overall message that violence is not a good solution, the lesson is unlikely to be grasped by younger viewers, who will be absorbed in the violent actions and emotions throughout the storyline. Repeated viewing of the same program can help overall comprehension of the plot, but even then, the moral is difficult for children under 8 to extract (Mares, 2006).

One last developmental consideration is the age of the perpetrator. As discussed above, people tend to like characters in the media who are most like themselves. It stands to reason, then, that young people will be most attracted to younger characters. Studies support this; children’s visual attention to the television screen increases when a child character appears (Schmitt et al., 1999). Moreover, children typically choose characters who are about their own age as their favorites (Cohen, 1999; Hoffner, 1996). Although there are far fewer child and teen perpetrators than adult ones on television (Wilson, Colvin, & Smith, 2002), these young aggressors are particularly salient for a younger viewer. Movies such as Super 8 or The Karate Kid, which feature young characters engaging in justified violence, are likely to be very appealing to children. Likewise, music videos, which often feature teen perpetrators (Wilson, Colvin, et al., 2002), can be potent


messages for preadolescent and adolescent audiences.

Relational or Social Aggression Up to this point, we have focused primarily on physical aggression as a possible outcome of exposure to media violence. Yet in the past decade or so, developmental psychologists have come to recognize that there are other, less overt ways to engage in aggression (Ostrov & Godleski, 2010). Relational or social aggression involves acts that are intended to harm others emotionally rather than physically. Examples include gossiping, spreading rumors, socially isolating others, or engaging in insulting or mean talk. These types of socially aggressive behaviors can occur in face-to-face situations, and they can even be perpetrated using the Internet. In recent national surveys, 17% of American youth report that they have been electronically bullied through instant messaging, in a chat room, or by email within the last year (Jayson, 2012).

Like physical aggression, social aggression emerges early in development, by age 3 or so (Crick, Ostrov, & Werner, 2006). However, unlike physical aggression, social aggression seems to be more common among girls than boys (Spieker et al., 2012). Public concern about this type of behavior has spawned a number of popular books with titles such as Queen Bees and Wannabes: Helping Your Daughter Survive Cliques, Gossip, Boyfriends, and the New Realities of Girl World. Popular movies such as Mean Girls and Diary of a Wimpy Kid also illustrate this type of behavior.

A handful of recent studies suggest that the media may be contributing to social aggression. One content analysis of the 50 most watched programs among 2- to 11-year-olds found that 92% of the shows contained social aggression (Martins & Wilson, 2012a). Moreover, an average of 14 different incidents of social aggression occurred per hour in these shows, or one every four minutes. The vast majority of these incidents (78%) were verbal in nature, with insults and name calling being the most common types (see Figure 4.12). Fewer of the incidents were nonverbal, and most of these involved making a mean facial expression at someone or laughing at someone. Similarly high levels of social aggression have been documented in prime-time programs (Glascock, 2008) and in programs popular with adolescents (Coyne & Archer, 2004). Research also suggests that adolescents are exposed to far more indirect and social aggression on


television than they are in school (Coyne, Archer, & Eslea, 2006).

But is there any evidence for a link between media exposure and relational aggression? One study of preschoolers found that media exposure was positively associated with physical aggression for boys and with relational aggression for girls (Ostrov, Gentile, & Crick, 2006). Unfortunately, the study did not cleanly assess the content of what children were watching. More recently, a longitudinal study of over 400 grade school children found that heavy exposure to media violence at the beginning of the school year predicted higher levels of both physical and relational aggression later in the year (Gentile, Coyne, & Walsh, 2011), even after controlling for age, sex, race, and parental involvement. However, the link between media violence and aggression was stronger for physical than for relational forms of this behavior. The researchers speculated that their measure of media violence exposure was too broad and might not have captured programs high in relational aggression in particular.

Figure 4.12 Types of verbal and nonverbal social aggression in programs popular among children.


SOURCE: Adapted from Martins and Wilson (2012a).

Addressing this issue, Martins and Wilson (2012b) looked specifically at children’s viewing of programs high in social aggression, as documented by their content analysis (Martins & Wilson, 2012a). Examples of such shows included American Idol, Suite Life of Zach & Cody, and Drake & Josh. Surveying over 500 children (K–5th grade), Martins and Wilson found that heavy exposure to televised social aggression was significantly related to greater social aggression in school, but only for girls and not for boys. The


researchers speculated that the lack of findings for boys might be due to the popularity of socially aggressive programming with girls and to sex differences in types of aggressive behavior. Interestingly, exposure to programs high in physical violence was not linked to social aggression (for girls or for boys), suggesting that the specific nature of the content and role modeling in violent programming is crucial.

Clearly, more research is needed on this provocative topic. It may be that our historical preoccupation with physical aggression has caused us to overlook other types of harmful outcomes of media violence, especially those that may be more prominent among girls.

Can Media Violence Desensitize Young People? Concern about children’s aggressive behavior has certainly dominated most of the public debates and the research on media violence. However, an outcome that may be far more pervasive is desensitization (see Figure 4.13). Desensitization refers to the idea that extensive exposure to a stimulus can lead to reduced emotional responsiveness to it. In clinical settings, desensitization techniques have been used to treat people’s phobias (Olatunji, Cisler, & Deacon, 2010). For example, a person who is frightened of dogs is gradually exposed under nonthreatening circumstances to a variety of these types of animals, often with cognitive coping skills accompanying the exposure treatment. Eventually, the person acclimates to dogs and the fear is eliminated. Can repeated exposure to media violence be similarly therapeutic?

We do know that repeated viewing of violent materials can affect a person’s arousal responses. For example, an early study found that boys who were heavy viewers of television exhibited less physiological arousal during selected scenes from a violent film than light viewers did (Cline, Croft, & Courrier, 1973). Likewise, adults who are habitual consumers of violent screen media show low levels of arousal while watching a violent film clip (Krahe et al., 2011). Other studies have documented that even within a single program, people’s heart rate and skin conductance go down over time during prolonged exposure to violence (Lazarus & Alfert, 1964; Speisman, Lazarus, Davison, & Mordkoff, 1964). Some critics have speculated that American films and television programs are becoming increasingly graphic and violent because audiences are desensitized to tamer versions of such content (Farr, 2012).


Figure 4.13

SOURCE: Reprinted with permission of Mike Luckovich and Creators Syndicate, Inc.

If repeated exposure to media violence merely resulted in decreased arousal, there might be little cause for concern. In fact, one could argue that a reduction in arousal is even functional, given that being in a heightened state of arousal for too long can be taxing to the body (Ursin & Eriksen, 2001). What alarms people is the possibility that desensitization to entertainment violence will in turn affect responses to real-life violence. In their book High Tech, High Touch: Technology and Our Search for Meaning, Naisbitt, Naisbitt, and Philips (1999) wrote,

In a culture of electronic violence, images that once caused us to empathize with the pain and trauma of another human being excite a momentary adrenaline rush. To be numb to another’s pain—to be acculturated to violence —is arguably one of the worst consequences our technological advances have wrought. That indifference transfers from the screen, TV, film, Internet, and electronic games to our everyday lives through seemingly innocuous consumer technologies. (pp. 90–91)

Research suggests that there is some merit to this concern. For example, one study found that both children and adults were less physiologically


aroused by a scene of real-life aggression if they had previously watched a violent drama on TV than if they had watched a nonviolent program (Thomas, Horton, Lippincott, & Drabman, 1977). In other words, the fictional portrayal produced an indifference to real-life violence. Violent video games can have a similar effect (see Chapter 10). In one recent experiment, college students who played a violent game for 20 minutes subsequently displayed less physiological arousal (i.e., heart rate and galvanic skin response) while watching a graphic videotape of real violence than did those who had played a nonviolent game (Carnagey, Anderson, & Bushman, 2007).

Even more troubling, can desensitization affect people’s willingness to intervene or take action on behalf of a victim? In one experiment (Thomas & Drabman, 1975), 1st and 3rd graders were shown either a violent or a nonviolent TV program and then placed in charge of monitoring the behavior of two preschoolers at play. Older children who viewed the violent TV show were significantly slower in seeking help when the preschoolers broke into a fight than were those who viewed the nonviolent show. In fact, more than half the older children in the violent TV condition never left the room even though they had been told to get an adult if trouble erupted. This type of callousness to real violence has been replicated in other media studies involving children (Drabman & Thomas, 1974; Molitor & Hirsch, 1994) and even adults (Bushman & Anderson, 2009).

Desensitization can also cause callousness to real-world crime. In a pair of studies, Linz, Donnerstein, and Penrod (1984, 1988) exposed male undergraduates over a two-week period to five full-length “slasher” films depicting violence against women, such as The Texas Chain Saw Massacre and The Toolbox Murders. After each film, emotional reactions, perceptions of violence in the films, and attitudes toward the women in the films were measured. Supporting the idea of desensitization, males perceived less violence in the films and evaluated the films as less degrading to women over the course of the exposure period. At the end of the viewing period, participants were asked to evaluate a videotaped enactment of a legal trial involving a rape victim. Compared with various control groups, males who had been exposed to a heavy dose of slasher films were less sympathetic toward a rape victim and more inclined to hold her responsible.

One critical question is whether desensitization is a transitory effect or a more permanent state that persists beyond the exposure period. That is, can people become resensitized to real-world violence? Mullin and Linz (1995)


tested this idea by varying the amount of time that lapsed between exposure to fictional violence and evaluations of real victims of violence. In this experiment, male college students were exposed to three slasher films over a six-day period. In a supposedly unrelated context, they were asked either three, five, or seven days later to watch a documentary about domestic abuse. The researchers found that three days after exposure, males expressed less sympathy for domestic violence victims and rated their injuries as less severe than did a no-exposure control group (see Figure 4.14). However, five and seven days later, levels of sympathy had rebounded to the baseline level of the control group. In other words, the desensitization effect seemed to diminish after about a three-day period.

Of course, resensitization requires that a person no longer be exposed to entertainment violence during the “recovery” period. As we have seen, most children watch between four and five hours of television per day, and many watch a great deal more. Given the pervasiveness of violence in this medium, heavy viewers are presumably exposed to a fairly constant diet of aggressive behaviors. If these same children also play violent video games, listen to violent music, and go to a violent film or two a month, there are ample occasions for desensitization to occur and not much of an opportunity to reestablish sensitivity to aggression.

Because desensitization is construed as an automatic process similar to habituation, it can happen without a person’s awareness. Furthermore, unlike aggression, which is easy to see, there are fewer outward manifestations of this type of effect.

Thus, large numbers of young people in our society may be gradually becoming desensitized by media violence without us ever knowing. The popularity in recent years of graphically violent movie series such as Rambo and Kill Bill and graphic TV series such as The Walking Dead suggests that we are already experiencing a cultural shift in our acceptance of violence in the media (Hayes, 2007). The danger, of course, is in the possibility that such an effect will spill over into real life, resulting in a society that is increasingly tolerant of aggression and indifferent to its victims.

Figure 4.14 Perceptions of domestic violence victim days after desensitization to media violence.


SOURCE: Adapted from Mullin and Linz (1995).

Can Media Violence Produce Fear? The third potential effect of media violence is to create fear in audiences (see Figure 4.15). Many of us can remember a movie or TV show that frightened us as a child. In one study, more than 90% of college students could vividly describe a film or television program that caused intense fear when they were younger (Harrison & Cantor, 1999). Psycho, Jaws, and The Exorcist were just a few of the more common movies cited (see Figure 4.16). Amazingly, one-fourth of these students said they were still bothered by what they had seen. And even though many of these movies are fictional, adults often report seemingly irrational long-term anxieties, such as fear of walking in the woods after seeing The Blair Witch Project (Cantor, 2004).

Such patterns are consistent with research involving children, too. Surveys indicate that a majority of preschoolers and elementary schoolers have experienced fright reactions to media programming, much of which is violent (Cantor, Byrne, Moyer-Gusé, & Riddle, 2010; Wilson, Hoffner, & Cantor, 1987). Furthermore, many of these reactions have endured beyond the viewing experience, resulting in nightmares, sleep disturbances, and even acute fears in some cases (see Cantor, 2009). In fact, studies have documented symptoms of posttraumatic stress disorder in young people as a result of media exposure to violent news events, such as the Oklahoma City bombing and the terrorist attacks on September 11, 2001 (Otto et al., 2007;


Pfefferbaum et al., 2000).

Figure 4.15

SOURCE: Jeff Stahler: © Columbus Dispatch/Dist. by Newspaper Enterprise Association, Inc.

Figure 4.16 Examples of movies that frighten children and teens.


The types of images that frighten children change as a function of age or developmental level (for reviews, see Cantor, 2009; Valkenburg & Buijzen, 2011). Preschoolers and younger elementary schoolers respond most to characters and scenes that look scary, consistent with the idea of perceptual dependence discussed in Chapter 1. Therefore, younger children are often frightened by programs that feature monsters, gory-looking characters, and witches. The Wizard of Oz and even certain Disney films are examples of


upsetting content for this age group. In contrast, older elementary school children are less upset by surface features and more concerned about whether a violent portrayal could happen in real life. Again, this is consistent with the gradual understanding of reality-fantasy distinctions. Thus, more realistic programs that involve harm to human beings, especially family members, are often cited as frightening by 8- to 12-year-olds. Interestingly, this age group is also more likely to be scared by TV news stories of violent crime than their younger counterparts are (Riddle, Cantor, Byrne, & Moyer-Gusé, 2012; Smith & Wilson, 2002). Adolescents respond to realistic depictions too, but their abstract thinking skills also allow them to imagine implausible and inconceivable events (see Chapter 1). Therefore, teens are far more susceptible than children to intangible threats in the media, such as global conflict, nuclear war, and political attacks (Cantor, Wilson, & Hoffner, 1986).

Gerbner and his colleagues took the idea of fear one step further, arguing that extensive exposure to media violence can lead to a greater sense of apprehension, mistrust, and insecurity about the real world (Gerbner & Gross, 1976; Gerbner, Gross, Morgan, & Signorielli, 1994). In other words, violence in the media can cultivate a “mean world syndrome” in viewers (Morgan, Shanahan, & Signorielli, 2009). According to cultivation theory, heavy exposure to television can alter a person’s perceptions of social reality in a way that matches the TV world. Given that television features so much violence, heavy viewers should come to see the world as more violent. In numerous studies with samples of all different ages, Gerbner and his colleagues consistently found that frequent viewers of television perceive the world as a more violent place and perceive themselves as more likely to become a victim of violence than light viewers do (see Morgan et al., 2009).

Cultivation theory has been rigorously critiqued by other researchers (Hawkins & Pingree, 1981; Hirsch, 1980; Hughes, 1980; Potter, 1993). One of the most widespread concerns is that most of the findings that support the theory are correlational. The cultivation effect does typically hold up even after controlling for demographic variables as well as other factors that could explain the relationship between TV and perceptions of reality (see Shanahan & Morgan, 1999). But even after controlling for “third” variables, it is difficult to determine the direction of causality from correlational data. Does television cause fear, or are frightened people drawn to watching more TV, in part because such content allows them to work out their fears? In support of cultivation theory, experimental evidence shows that repeated


exposure to television violence, for as little as one week or as much as six weeks, under controlled conditions can heighten fear and anxiety in viewers (Bryant, Carveth, & Brown, 1981; Ogles & Hoffner, 1987). However, research also shows that crime-apprehensive people seek out violent drama, especially that which features the restoration of justice (Zillmann & Wakshlag, 1985). As with aggression, then, the relationship between entertainment violence and anxiety may be cyclical in nature.

A second criticism of the theory is that it assumes all television content is alike and that what matters most in predicting cultivation is the sheer amount of exposure to TV. We have already seen that PBS features relatively little violence (Wilson et al., 1998), so it stands to reason that if a child selectively watches that channel, there will be less likelihood of enhanced fear. Research also suggests that cultivation is heightened among those who watch a great deal of news content (Romer, Jamieson, & Aday, 2003). Thus, a person’s television habits and favorite genres seem to be important factors to consider. Furthermore, technological developments such as cable and satellite networks, DVRs, pay-per-view, and the Internet have changed the face of “television” so that it is no longer a uniform experience. Yet despite all these innovations, Morgan (2009) argues that TV content and people’s habits have not changed much over the years.

A third criticism is that the theory is too simplistic because it predicts an effect for anyone who watches a lot of television. In fact, not all of the subgroups in Gerbner’s studies show a cultivation effect (Gerbner et al., 1980), suggesting that intervening variables are at work. Some studies indicate that cultivation is more likely to occur among those who perceive television as realistic (e.g., Busselle, 2001). Also, research suggests that personal experience with crime and one’s motivation for viewing television (i.e., to learn versus to escape) may be important mediating factors (Gross & Aday, 2003; Perse, 1990). In addition, the cognitive abilities of the viewer may make a difference. Preschoolers, for example, lack the ability to distinguish reality from fantasy and the ability to integrate information from a program, so their perceptions may be less influenced by media content (Hawkins & Pingree, 1980). However, studies have found that by the elementary school years, exposure to news programming on TV is associated with exaggerated perceptions of murder and even child kidnapping (Smith & Wilson, 2002; Wilson, Martins, & Marske, 2005).

Finally, the theory has paid little attention to the cognitive processes that underlie cultivation. Shrum (2009) has argued that cultivation is a result of


heuristic processing. Compared with more careful, systematic processing, heuristic processing is characterized by rapid and less careful thinking as well as the reliance on cognitive shortcuts and readily available or salient information. According to Shrum, most people engage in heuristic processing when asked to make judgments. Moreover, heavy viewers of television have numerous salient examples of violence stored in their memory. The more a person watches violent programming, the more accessible these exemplars are and the more likely they will be used in making judgments about social reality (see Shrum & Lee, 2012). In support of this model, one study found that college students who were encouraged to think carefully and accurately in answering questions about the incidence of crime in the world were less likely to show a cultivation effect than students who were encouraged to make rapid judgments or students who were given no instructions about how to answer the questions (Shrum, 2001). In other words, careful, systematic processing truncated the cultivation effect. In further support of heuristic processing, a recent experiment by Riddle (2010) found that people are more likely to show a cultivation effect after viewing repeated violence on television that is vivid (e.g., close-up shots of violence, blood, gore) compared to nonvivid. Here, the vividness presumably enhances memory and accessibility of those images when making subsequent judgments. Altogether, this newer research suggests that cultivation is a function of the extent to which people engage in heuristic processing and have lots of vivid instances of screen violence stored in memory.

Despite the criticisms of cultivation theory, there is still a great deal of evidence supporting the idea that media violence can make children, teens, and even adults feel more anxious about the real world. The challenge for the future is to better understand how and when these fear effects occur. Also, research needs to explore the relationship between fear and desensitization, which seem like contradictory outcomes. Perhaps repeated exposure to media violence frightens some and numbs others, depending on the nature of the content that is sought as well as the type of individual who seeks it.

Cultural Debates About Media Violence Despite all the evidence presented here, there are critics who do not agree that media violence is harmful. Some of the most vocal opponents are


people who work in the industry. To many of them, media violence has become a convenient scapegoat for politicians who refuse to grapple with more deep-seated causes of violence, such as gun access and poverty (Bradshaw, 2012). Another argument often made is that good drama requires conflict and conflict means violence (Braxton, 1991). Others in the industry argue that media violence will disappear if people simply quit watching it and paying for it (Pool, 1991). In other words, in the marketplace of American culture, consumers are ultimately responsible for the violence that surrounds us. Violence does seem to attract audiences, as we discussed above. Yet there are many examples of good storytelling with little or no physical aggression. Cartoon series such as Doc McStuffins, situation comedies such as Modern Family, and even movies such as Dolphin Tale and The Help illustrate this point. One of the problems is that violence is relatively easy and cheap to produce and has a strong international market (Groebel, 2001). Action movies seem to translate fairly easily across cultural, national, and linguistic borders.

There are also scholars who challenge the research, as noted earlier in this chapter. Some are social scientists themselves, and they critique the validity and reliability of the studies. For example, Freedman (2002) points out the limitations of laboratory studies, field experiments, and correlational research and concludes that the evidence does not yet support a causal relationship between TV violence and aggression. Similarly, Ferguson and Kilburn (2009) and Savage and Yancey (2008) question the existence of effects, based on their own statistical analyses of the research. Other scholars argue that focusing on the “effects” of media violence on children is too simplistic and unidimensional, ignoring how young people choose, interpret, and negotiate violent media texts in their lives (Buckingham, 2000). Still others believe that social science research obfuscates larger issues, such as how media violence as a cultural institution legitimates power and control in our society (Ball-Rokeach, 2000). A more radical view is represented by Fowles (1999), who believes that media violence is therapeutic for people. At least in the social science arena, though, there is little evidence to support this position.

Obviously, there are many points of view regarding media violence. The debates are often intense, and given the stakes involved, there are no easy solutions. Social scientists are increasingly joining the public discussions and grappling with the politics of their work (Bushman & Anderson, 2001; Huesmann, Dubow, & Yang, 2013). The challenge, it seems, is to stay focused on children in the midst of these political and scholarly disputes.


Guns and the Media Firearms play a leading role in mortality and morbidity among American

youth (Children’s Defense Fund [CDF], 2012). In fact, the leading cause of death among African American males between the ages of 15 and 19 is gun homicide. Moreover, the death rate due to firearms among U.S. teens and young adults is 43 times higher than among young people in 23 other industrialized countries combined (CDF, 2012). In 2008 and 2009 alone, a total of 5,740 children and teens died from guns in the U.S., which translates to one child or teen every three hours, or eight youth a day (CDF, 2012). During this same two-year period, over 34,000 American youth suffered nonfatal gun injuries.

There is little doubt that the United States is “the most heavily armed nation on earth” (O. G. Davidson, 1993), with approximately one-third of homes with children younger than 18 years of age having at least one firearm (Johnson, Coyne-Beasley, & Runyan, 2004). In a good number of these homes, especially homes with teens, the firearms are unlocked and either loaded or stored near ammunition (Johnson, Miller, Vriniotis, Azrael, & Hemenway, 2006). And young people seem to know it. In one national survey, 24% of adolescents reported that they had “easy access” to a gun in their home (Swahn, Hammig, & Ikeda, 2002). In another national study, 16% of American youth (and 25% of males) reported that they had carried a handgun by the age of 17 (Snyder & Sickmund, 2006).

Unfortunately, guns kept at home can be more dangerous to the people who live there than to any criminal intruder (Kellermann et al., 1993; Kellermann, Somes, Rivara, Lee, & Banton, 1998). In one 5-year study of youth brought to a medical trauma center, 75% of the guns used in suicide attempts and unintentional injuries came from the victim’s home or the home of a relative or friend (Grossman, Reay, & Baker, 1999). In another study in New Mexico, 25 unintentional firearm deaths and 200 woundings were identified within a four-year period, mostly involving children playing with loaded guns at home (Martin, Sklar, & McFeeley, 1991).

Large epidemiological studies show that keeping a gun in the home increases the risk of suicide and homicide among the adults who reside there (Miller, Lippmann, Azrael, & Hemenway, 2007) and even increases the risk of suicidal tendencies and violence among teen residents (Resnick et al., 1997). One study found that the odds of a depressed teenager successfully committing suicide increase 75-fold if there is a gun kept at home (Rosenberg, Mercy, & Houk, 1991). Yet nearly 2 million children and


youth in the United States are living in homes with loaded and unlocked firearms (Okoro et al., 2005). Furthermore, 23% of gun-owning parents believe that their child can be trusted with a loaded gun (Farah, Simon, & Kellermann, 1999).

One study graphically demonstrates just how naive children can be about firearms. Jackman, Farah, Kellermann, and Simon (2001) observed more than 60 boys between the ages of 8 and 12 as they played in a room full of toys. The room also contained an unloaded .380-caliber handgun concealed in a drawer. Within 15 minutes of play, the vast majority of boys (75%) discovered the gun. More disturbing, 63% of the boys who found the gun handled it, and 33% actually pulled the trigger. When questioned afterward, almost half of the boys who found the gun thought it was a toy or were not sure whether it was real. Children from gun-owning families behaved no differently than children from non-gun-owning families.

Despite all the risks, many Americans seem to have a long-standing love of guns, and this passion is frequently played out in the movies and on television. A recent study of 100 top-grossing movies between 1995 and 2004 found that a full 70% featured at least one scene with a firearm (Binswanger & Cowan, 2009). Furthermore, firearm depictions accounted for 17% of the screen time in these movies, and messages about gun safety were “exceedingly rare.” The majority of the films featuring firearms were rated PG-13 and could be viewed readily by older children and teens. But such images are not limited to the movies (see Figure 4.17). Young children can witness laser guns and a variety of other types of firearms being used in cartoons such as Green Lantern and even Looney Tunes. Using data from the National Television Violence Study described above, Smith, Boyson, Pieper, and Wilson (2001) found that 26% of all violent incidents in a composite week of television involved the use of a gun. Three types of programming accounted for most of this gun violence: movies (54%), dramatic series (19%), and children’s shows (16%). In terms of rate, a child viewer will see, on average, nearly two gun-related violent incidents every hour that she or he watches TV. That rate goes up if the child selectively watches gun-filled genres such as movies or children’s shows.

According to cognitive priming theory, images of guns in the media can trigger aggressive thoughts and ideas in young viewers. In one experiment, just flashing pictures of guns and other weapons on a computer screen served to prime aggressive-related thoughts in college students (Anderson, Benjamin, & Bartholow, 1998). In other words, a gun need not even be fired


to incite aggression. In support of this idea, a meta-analysis of 56 experiments found that the mere presence of weapons, either pictorially or in the natural environment, significantly enhanced aggression among angered as well as nonangered adults (Carlson et al., 1990).

Clearly, the portrayal of guns in entertainment media is a public health concern. For many young children, television will be the first place they encounter such weapons. Repeated exposure to images of heroes and other attractive role models using firearms will at the very least help to glorify these deadly devices. Even the news can draw attention to gun use. Some have criticized the television networks for airing graphic images of the gunmen and their weapons in stories about the massacres at Virginia Tech and Aurora, Colorado, in part because such publicity gives undue notoriety to deranged individuals (Bauder, 2012; Klimkiewicz, 2007).

Figure 4.17 Images of guns in television, films, and video games.

Suicide and the Media Suicide is the third leading cause of death among youth between the ages


of 10 and 24 (CDC, 2011). However, many teens consider suicide without attempting it or attempt it without being successful. Suicidal thoughts are alarmingly common among teenagers. In a recent national survey, 16% of all high schoolers reported having seriously considered attempting suicide in the previous 12 months, and 13% had actually made a plan about how they would do it (Youth Risk Behavior Surveillance System, 2012). Given such statistics, having firearms in the home and making firearms a common feature in the media both seem like dangerous practices.

In addition to glorifying guns, the media may contribute to adolescent suicide by highlighting such behavior in public cases (Phillips, Carstensen, & Paight, 1989). On April 5, 1994, lead singer Kurt Cobain of the popular rock group Nirvana put a shotgun to his head and pulled the trigger. This highly publicized suicide prompted a great deal of public concern about the potential of the event to spark copycat behaviors among anguished teen fans (Jobes, Berman, O’Carroll, Eastgard, & Knickmeyer, 1996). In fact, a large number of studies, both in the United States and Europe, have demonstrated a link between media coverage of suicide and subsequent increases in such behavior among teens (for reviews, see Pirkis & Nordentoft, 2011; Sisask & Varnik, 2012). This contagion effect has been found for both TV news coverage and newspaper coverage of stories (Romer, Jamieson, & Jamieson, 2006). The effect is enhanced by prominent coverage and repetition of the news stories (Etzersdorfer, Voracek, & Sonneck, 2004). Furthermore, the impact is strongest within the first three days of media coverage and then seems to level off after about two weeks (Phillips & Carstensen, 1986), although it can last longer (Fu & Yip, 2007).

One key factor in this phenomenon may be the extent to which a susceptible teen identifies with the publicized suicide victim (L. E. Davidson, Rosenberg, Mercy, Franklin, & Simmons, 1989). In support of this idea, a meta-analysis of 55 studies on the effect of suicide stories in the news found that the risk of contagion was significantly greater when a celebrity was involved (Stack, 2005). However, because the studies to date have all involved large numbers of young people, it is difficult to know precisely which factors influenced any particular individual. In addition, although such research typically controls for factors such as time of year and yearly trends in suicide, the data are still only correlational, so they are always subject to alternative explanations.

Fictional media content can also portray suicide stories. Popular films such as The Virgin Suicides and A Beautiful Mind focus on characters


struggling with mental illness and suicidal tendencies. Other films such as Romeo and Juliet almost seem to celebrate suicide by depicting it as a heroic act. There is some evidence to suggest that the depiction of suicidal themes in feature-length films has increased over the years (see Jamieson & Romer, 2011). Furthermore, exposure to such films has been linked to particular beliefs about mental illness. One national survey found that among adolescents and young adults identified as depressed/suicidal, frequent viewing of films with mentally disturbed characters was associated with less confidence in the effectiveness of mental health treatments (Jamieson, Romer, & Jamieson, 2006). Among nontroubled youth, however, there was no relationship between film exposure and treatment beliefs. The researchers speculated that movies that glorify suicide and fail to model successful coping techniques may be teaching young people about the futility of seeking help. Because these data are correlational, it could also be that troubled youth who are already skeptical about treatment are seeking out these types of films.

Newer media also present information about suicide for the curious or depressed young person. There are websites that can be characterized as “prosuicidal,” online chat rooms and virtual bulletin boards that provide digital spaces for users to discuss suicidal ideations, and even YouTube videos that demonstrate self-injury techniques such as cutting and burning (see Luxton, June, & Fairall, 2012). A recent national study of 14- to 24- year-olds found that most youth (64%) had “heard or seen a story about someone who committed suicide in the past few months” in a newspaper, but 24% reported that they had been exposed to a suicide story on a social networking site and 15% said they had learned of a suicide case from an online forum or self-help website (Dunlop, More, & Romer, 2011). Thus, concerns about contagion effects increasingly need to consider social media rather than just traditional news outlets.

Clearly, the causes of suicidal behaviors are complex and multifold (Amitai & Apter, 2012). Nevertheless, research supports the above- mentioned idea known in the medical field as suicide “contagion” (Insel & Gould, 2008), whereby exposure to the suicide of one person encourages others to attempt such behavior. The contagion effect appears to be stronger among adolescents than adults (Gould, Wallenstein, Kleinman, O’Carroll, & Mercy, 1990), which is quite consistent with the idea that suicidal tendencies might be learned and/or primed by observing the behavior of others. Given that troubled teens do seem to take notice of public suicides, the CDC and the American Association of Suicidology have issued


guidelines for reporting suicide in the media (see folderId=236&name=DLFE-336.pdf). They recommend that news stories avoid sensationalizing the act, glorifying the person involved, or providing how-to details. Recent evidence indicates that U.S. newspapers are not doing a very good job of following these guidelines (Tatum, Canetto, & Slater, 2010). Such guidelines could apply just as readily to entertainment programs that feature suicide in the plot or to websites that focus on suicide information.

Japan Versus the United States: A Cross-Cultural Comparison

The only country in the world with nearly as much entertainment violence as the United States is Japan. Yet Japanese society is far less violent than American society (United Nations Office on Drugs and Crime, 2012). If media violence contributes to real-life aggression, why is Japan not more affected? There are several important differences between the two countries. First, the portrayal of violence is different in Japan. Compared with American television, programming in Japan more heavily emphasizes the negative consequences of violence in the storyline (Iwao, Pool, & Hagiwara, 1981; Kodaira, 1998). Interestingly, in Japan, the “bad guys” commit much of the TV violence, with the “good guys” suffering the consequences—a pattern opposite to what is found in American programming (Smith et al., 1998). As discussed earlier, featuring unattractive perpetrators and showing victim pain both reduce the risk that a portrayal will encourage aggression in viewers.

Second, children are raised in fairly traditional family structures with a strong emphasis on discipline and control. Third, Japan has very strict gun control laws. Individuals are not allowed to own guns, and very few exceptions are allowed. The only type of firearm a citizen may acquire is a shotgun, for hunting purposes only, and only after a lengthy licensing procedure involving classes, a written exam, and medical certification of mental health (Kopel, 1993). After a wave of shootings by gangs in 2007, Japan strengthened its already-strict gun control laws by imposing a 1- to 15-year prison sentence or a fine of up to 5 million yen ($46,100) for possession of a gun as part of organized crime (Nishiyama, 2007).

Despite these cultural differences, teen violence in Japan is on the rise.


By U.S. standards, the figures are still low. But the number of minors younger than age 14 who committed violent crimes increased 47% from 2002 to 2003 (Faiola, 2004). The recent surge in youth violence has led some to point fingers at the increasingly violent nature of Japanese media (Faiola, 2004). Often quite graphic, Japanese anime or animation is exported worldwide in the form of comic books, cartoons, short films, and video games (Bosker, 2007). Others have blamed the escalation of violence in Japan on an intensive educational system and a breakdown in traditional values (Lies, 2001). Japan can still be considered a relatively peaceful country relative to the United States, but the celebration of violence in popular culture there is giving rise to public concern. Indeed, a longitudinal study of Japanese and American youth found that playing violent video games predicted increased physical aggression three to six months later in both countries, even after controlling for gender and initial aggressiveness (Anderson et al., 2008). Moreover, the size of the effect was similar for the two countries, despite Japan’s being a “low-violence” culture. The researchers concluded,

That both cultures yielded significant longitudinal effects of approximately the same magnitude illustrates the power of violent video games to affect children’s developmental trajectories in a harmful way. These findings also further suggest that common social learning processes underlie media violence effects across cultures, and contradict another popular alternative hypothesis: that only highly aggressive children (either by nature, culture, or other socialization factors) will become more aggressive if repeatedly exposed to violent video games. (p. e1070)

Can Media Violence Have Positive Effects? Much of this chapter has focused on the negative effects of exposure to media violence. However, violent portrayals can have prosocial effects as well. In 1998, Court TV (now called truTV) commissioned a study to assess whether television violence could help teach young people to be less aggressive (Wilson et al., 1999). In the study, 513 young adolescents from three different middle schools in California were randomly assigned to receive or not receive an antiviolence curriculum in school. The Choices and Consequences curriculum was presented by the regular teachers during normal class time. The three-week curriculum involved watching videotaped court cases about real teens who had engaged in risky behavior


that resulted in someone dying. In one case, for example, a group of teens pushed a young boy off a railroad trestle and he drowned.

Each week, students watched portions of the videotaped trial, discussed them in class, engaged in role playing activities, and completed homework assignments based on the trial case. Compared with the no-curriculum control group, the intervention significantly reduced middle schoolers’ verbal aggression and curbed their physical aggression. The curriculum also increased empathic skills and knowledge of the legal system. In other words, exposure to programming that emphasized the lifelong negative consequences of antisocial behavior had prosocial effects on teens.

Other types of critical viewing curricula have been tested as well. For example, Huesmann, Eron, Klein, Brice, and Fischer (1983) had 2nd and 4th graders write essays about the harmful effects of television violence and the unrealistic nature of particular violent shows. Then the children were videotaped while they read their essays; the footage was purportedly to be used to create a film about the problems of media violence. Compared with a control group that wrote essays about hobbies, the intervention group showed several positive effects. The intervention significantly altered children’s attitudes about TV violence, decreased their aggressive behavior, and eliminated the relationship between TV violence and aggressive behavior. Most of these effects were measured four months after the intervention, suggesting that a rather simple treatment can produce lasting changes.

In support of this earlier work, a recent meta-analysis of nine studies found that media literacy programs can be effective in changing how people respond to screen violence (Jeong, Cho, & Hwang, 2012). Such efforts are consistent with more broad-based curricular programs designed to teach media literacy to children (see Chapter 12).

Even in the absence of instructions or structured lessons plans, though, programs that treat violence in a sensitive manner can have a positive impact on audience members. One large-scale experiment found that a made-for-TV movie about acquaintance rape increased adults’ concern about the societal problems associated with rape and also reduced their acceptance of rape myths (Wilson, Linz, Donnerstein, & Stipp, 1992). Another study documented similar educational benefits of watching a TV movie about date rape among high schoolers (Filotas, 1993). However, both of these studies found that among some people, the intervention actually had a “boomerang” effect. In other words, teaching about the perils of media


violence enhanced aggressive attitudes among certain groups. Such findings serve as a caution for those who wish to design such interventions. Knowing the audience and their preexisting attitudes is a first step. In addition, a recent experiment suggests that showing violent clips, even in the context of instructions that attempt to educate about violence, may inadvertently prime aggressive thoughts and attitudes among children (Byrne, Linz, & Potter, 2009). Thus, visual images that glamorize violence need to be used with care. Although no empirical tests have confirmed this, movies such as Hotel Rwanda, Mystic River, and Blood Diamond that portray the realistic consequences of violence may be less likely to prime aggression in viewers and therefore could be more effective in educating youth about the personal and societal costs associated with aggression.

Conclusion Today there is strong consensus among most researchers that exposure to aggressive messages on television and in movies can have harmful effects on youth (Report of the Media Violence Commission, 2012). The most well- documented effect concerns aggression. Experimental studies, correlational research, longitudinal studies, and meta-analyses of published data all point to the same conclusion: Aggression is a learned behavior that can be acquired, reinforced, and primed by media messages. Young children are particularly vulnerable, as are children who strongly identify with violent characters, who are doing poorly in school, who perceive television as realistic, and who are unpopular with peers. The evidence does not suggest that media violence is the major cause of violence in society, but it is a socially significant one. The media are part of a complex web of cultural and environmental factors that can teach and reinforce aggression as a way of solving problems.

Yet aggression is not the only possible outcome. Extensive exposure to media violence can also desensitize some young people and make them more callous toward real-world violence. In others, it can lead to exaggerated concern and fear of becoming a victim of violence. None of these outcomes is straightforward and universal. Instead, certain children and teens are more vulnerable depending on their cognitive development, the types of media violence they like, and the amount of exposure they have to media violence in relation to other types of messages.

Given all these potential risks, one could advocate the elimination of


violence from the media. But violence does seem to turn a profit, at least with some audiences, so it is unlikely that it will ever go away in a free- market society. Nor should we necessarily try to make it do so. As we see in Chapter 13, policymakers walk a fine line between respecting the First Amendment rights of media makers and attempting to protect special audiences, like children, who may be vulnerable to the negative effects of exposure to violent media. Additionally, research shows quite clearly that certain portrayals are less harmful than others and that some depictions can actually have educational or prosocial effects on youth. The challenge for parents and educators is to ensure that youth are exposed to these alternative messages that accurately portray the seriousness of violence in society. The challenge to the media industry is to create more of these alternative messages and to ensure that they are just as appealing as those that glorify violence.

Exercises 1. Suppose you were asked to monitor the amount of violence on

television. How would you define violence? What types of issues would need to be considered in crafting your definition? Would you include fantasy violence? Would you include slapstick violence? How might your definition differ if you were a media researcher versus an executive in the television industry? What channels would you include in your study? What challenges, if any, would technologies such as TiVo and other digital video recording (DVR) devices pose for your study?

2. What is the most violent movie or television program you have ever seen? What made it so violent? Did you enjoy the program? Why or why not? If you were a parent, would you let your 6-year-old watch this program? Your 10-year-old? Your 15-year-old? Think about cognitive development as well as the nature of the content in addressing these questions.

3. Watch a popular cartoon and an evening crime drama on television. Compare the two in terms of how violence is portrayed. Think about contextual features such as the nature of the perpetrators, whether violence is rewarded or punished, and the consequences of violence. According to the research cited in this chapter, which program poses more risk to a young child viewer? Why?


4. In 1999, Mario Padilla and Samuel Ramirez, two teenage cousins, said the movie Scream inspired them to kill one of their mothers. That same year, two troubled teens who were obsessed with violent video games walked into Columbine High School and started shooting. Media violence is often blamed in these and many other “copycat” behaviors. Should the media be placed on trial? Divide into groups and develop arguments that might be used in a criminal case against such youth. Who or what is responsible for violence in these instances? Should writers and producers be held to any standards regarding the violent material they create?

5. Critics charge that television news is more violent than ever, often relying on the “If it bleeds, it leads” rule of practice. Is TV news too violent? Should news be treated differently than fictional content in the debates about media violence? In addressing this issue, consider what constitutes news versus entertainment programming. Is there a difference? Where do reality-based programs such as Cops and Police POV fit in?

6. Bullying is receiving a great deal of attention in America these days. Do you think media violence is contributing to this problem among youth? Why or why not? Can you think of instances of bullying that are portrayed in popular media? Are there ways we could use the media to teach children about the seriousness of bullying? Based on the research cited in the section titled “Can Media Violence Have Positive Effects?” as well as on other studies you can find, design an intervention program that could help reduce bullying among youth. Make sure you use the media in your intervention program.

7. In his provocative book Channeling Violence: The Economic Market for Violent Television Programming, James Hamilton (1998) argues that television violence, like pollution, generates negative externalities or costs that are shouldered by others rather than the people who produce the material. Using pollution as an analogy, he goes on to say that restrictions should be devised that place more responsibility on the TV industry while still protecting artistic freedom. For example, a violence tax could be imposed on those responsible for aggressive portrayals. How might such a tax work? Who should pay, and how should the amount be determined? Can you think of other approaches that could be implemented, using the pollution comparison? Would such efforts be constitutional?

8. Think back to your childhood. Can you remember a TV program or


movie that really frightened you? How old were you? How long did your fear last? What aspect of the show frightened you? Did you change your behavior in any way as a result of seeing this show? Analyze your reaction in light of what we know about cognitive development and children’s fear reactions to media, as discussed in this chapter.

9. In the debates about media violence, much less attention has been paid to desensitization as a harmful outcome than to aggression. Can you think of an occasion during which you felt desensitized to media violence? If our society gradually becomes desensitized to media violence, what are some of the possible outgrowths of this? Will it affect parenting? Will it affect the legal system? Explore some of the ways desensitization could affect individuals as well as our culture. You should look at a recent study by Engelhardt, Bartholow, Kerr, and Bushman (2011) that connects desensitization to aggressive behavior.

10. America is a violent country. Do you believe that the media have been unfairly blamed in public debates about this problem? Think about how you would respond to such a question if you worked in the media industry. Now think about how you would respond if you were a parent of a young child who had been seriously injured by a friend on the playground who was imitating a cartoon superhero. Defend your responses from these two different perspectives, using strong arguments based on research evidence to support your positions.


Abelson, R. P. (1976). Script processing in attitude formation and decision- making. In J. Carroll & J. Payne (Eds.), Cognition and social behavior (pp. 33–45). Hillsdale, NJ: Lawrence Erlbaum.

Aluja-Fabregat, A. (2000). Personality and curiosity about TV and films violence in adolescents. Personality and Individual Differences, 29, 379–392.

American Academy of Pediatrics. (2009). Policy statement—media violence. Pediatrics, 124(5), 1495–1503.

American Medical Association. (2008). National Advisory Council on Violence and Abuse: Policy compendium. Retrieved from

281 Amitai, M., & Apter, A. (2012). Social aspects of suicidal behavior and

prevention in early life: A review. International Journal of Environmental Research and Public Health, 9(3), 985–994.

Anderson, C. A., Benjamin, A. J., Jr., & Bartholow, B. D. (1998). Does the gun pull the trigger? Automatic priming effects of weapon pictures and weapon names. American Psychological Society, 9, 308–314.

Anderson, C. A., Berkowitz, L., Donnerstein, E., Huesmann, L. R., Johnson, J. D., Linz, D., . . . Wartella, E. (2003). The influence of media violence on youth. Psychological Science in the Public Interest, 4(3), 81–110.

Anderson, C. A., Sakamoto, A., Gentile, D.A., Ihori, N., Shibuya, A., Yukawa, S., . . . Kobayashi, K. (2008). Longitudinal effects of violent video games aggression in Japan and the United States. Pediatrics 122, 1067–1072.

Archer, D. (1994). American violence: How high and why? Law Studies, 19, 12–20.

Arnett, J. J. (1995). The soundtrack of recklessness: Musical preferences and reckless behavior among adolescents. Journal of Adolescent Research, 7, 313–331.

Atkin, C. (1983). Effects of realistic TV violence vs. fictional violence on aggression. Journalism Quarterly, 60, 615–621.

Auletta, K. (1993, May 17). Annals of communication: What they won’t do? New Yorker, 69, 45–53.

Ball-Rokeach, S. J. (2000, June). The politics of studying media violence: Reflections thirty years after the violence commission. Paper presented at the annual meeting of the International Communication Association, Acapulco, Mexico.

Bandura, A. (1965). Influence of models’ reinforcement contingencies on the acquisition of imitative response. Journal of Personality and Social Psychology, 1, 589–595.

Bandura, A. (1986). Social foundations of thought and action: A social cognitive theory. Englewood Cliffs, NJ: Prentice Hall.

Bandura, A. (2009). Social cognitive theory of mass communication. In J. Bryant & M. B. Oliver (Eds.), Media effects: Advances in theory and research (pp. 94–124). New York, NY: Routledge.

Bandura, A., Ross, D., & Ross, S. A. (1961). Transmission of aggression through imitation of aggressive models. Journal of Abnormal and Social Psychology, 63, 575–582.


Bandura, A., Ross, D., & Ross, S. A. (1963a). Imitation of film-mediated aggressive models. Journal of Abnormal and Social Psychology, 66, 3– 11.

Bandura, A., Ross, D., & Ross, S. A. (1963b). Various reinforcement and imitative learning. Journal of Abnormal and Social Psychology, 67, 601–607.

Baron, R. A. (1971a). Aggression as a function of magnitude of victim’s pain cues, level of prior anger arousal, and aggressor-victim similarity. Journal of Personality and Social Psychology, 18, 48–54.

Baron, R. A. (1971b). Magnitude of victim’s pain cues and level of prior anger arousal as determinants of adult aggressive behavior. Journal of Personality and Social Psychology, 17, 236–243.

Baron, R. A. (1978). The influence of hostile and nonhostile humor upon physical aggression. Personality and Social Psychology Bulletin, 4, 77– 80.

Bauder, D. (2012, July 24). Aurora shooting: Victims’ families urge television networks to use James Holmes’ name less. Retrieved from networks-name_n_1701093.html

Bauer, N. S., Herrenkohl, T. I., Lozano, P., Rivara, F. P., Hill, K. G., & Hawkins, J. D. (2006). Childhood bullying involvement and exposure to intimate partner violence. Pediatrics, 118(2), e235–e242.

Belson, W. A. (1978). Television violence and the adolescent boy. Westmead, UK: Saxon House, Teakfield.

Benton Foundation. (2005, October 11). New poll finds escalating violence in children’s TV now a crisis for parents. Retrieved from

Berkowitz, L. (1970). Aggressive humor as a stimulus to aggressive responses. Journal of Personality and Social Psychology, 2, 359–369.

Berkowitz, L. (1973). Words and symbols as stimuli to aggressive responses. In J. F. Knutson (Ed.), Control of aggression: Implications from basic research (pp. 113–143). Chicago, IL: Aldine-Atherton.

Berkowitz, L. (1984). Some effects of thoughts on anti- and prosocial influences of media events: A cognitive-neoassociation analysis. Psychological Bulletin, 95, 410–427.

Berkowitz, L. (1990). On the formation and regulation of anger and aggression: A cognitive neoassociationistic analysis. American Psychologist, 45, 494–503.


Berkowitz, L., & Powers, P. C. (1979). Effects of timing and justification of witnessed aggression on the observers’ punitiveness. Journal of Research in Personality, 13, 71–80.

Berry, M., Gray, T., & Donnerstein, E. (1999). Cutting film violence: Effects on perceptions, enjoyment, and arousal. Journal of Social Psychology, 139, 567–582.

Binswanger, I. A., & Cowan, J. A. (2009). Firearms in major motion pictures, 1995–2004. Journal of Trauma Injury, Infection, and Critical Care, 66(3), 906–911.

Bleakley, A., Jamieson, P., & Romer, D. (2012). Trends of sexual and violent content by gender in top-grossing U.S. films, 1950–2006. Journal of Adolescent Health, 51, 73–79.

Bosker, B. (2007, August 31). Manga mania. Wall Street Journal. Retrieved from

Boyatzis, J., Matillo, G. M., & Nesbitt, K. M. (1995). Effects of the Mighty Morphin Power Rangers on children’s aggression with peers. Child Study Journal, 25, 45–55.

Bradshaw, P. (2012, July 21). Will the Dark Knight Rises shootings revive the debate on “copycat” crimes? Retrieved from shootings-copycat-crimes

Braxton, G. (1991, July 31). Producers defend violence as honest. Los Angeles Times, pp. F1, F14.

Brito, N., Barr, R., McIntyre, P., & Simcock, G. (2012). Long-term transfer of learning from books and video during toddlerhood. Journal of Experimental Child Psychology, 111(1), 109–119.

Brown, M. H., Skeen, P., & Osborn, D. K. (1979). Young children’s perception of the reality of television. Contemporary Education, 50, 129–133.

Bryant, J., Carveth, R. A., & Brown, D. (1981). Television viewing and anxiety: An experimental examination. Journal of Communication, 31(1), 106–109.

Buckingham, D. (2000). After the death of childhood: Growing up in the age of electronic media. Cambridge, UK: Polity.

Bushman, B. J., & Anderson, C. A. (2001). Media violence and the American public: Scientific facts versus media misinformation. American Psychologist, 56, 477–489.

Bushman, B. J., & Anderson, C. A. (2009). Comfortably numb:


Desensitizing effects of violent media on helping others. Psychological Science, 20(3), 273–277.

Bushman, B. J., & Geen, R. G. (1990). Role of cognitive-emotional mediators and individual differences in the effects of media violence on aggression. Journal of Personality and Social Psychology, 58, 156–163.

Bushman, B. J., & Huesmann, L. R. (2001). Effects of televised violence on aggression. In D. G. Singer & J. L. Singer (Eds.), Handbook of children and the media (pp. 223–254). Thousand Oaks, CA: Sage.

Bushman, B. J., Huesmann, L. R., & Whitaker, J. L. (2009). Violent media effects. In R. L. Nabi & M. B. Oliver (Eds.), Media processes and effects (pp. 361–376). Thousand Oaks, CA: Sage.

Bushman, B. J., Rothstein, H. R., & Anderson, C. A. (2010). Much ado about something: Violent video game effects and a school of red herring: Reply to Ferguson and Kilburn (2010). Psychological Bulletin, 136(2), 182–187.

Busselle, R. W. (2001). The role of exemplar accessibility in social reality judgments. Media Psychology, 3, 43–68.

Byrne, S., Linz, D., & Potter, J. (2009). A test of competing cognitive explanations for the boomerang effect in response to the deliberate disruption of media-induced aggression. Media Psychology, 12(3), 227– 248.

Calvert, S. L., Murray, K. J., & Conger, E. E. (2004). Heroic DVD portrayals: What US and Taiwanese adolescents admire and understand. Journal of Applied Developmental Psychology, 25(6), 699–716.

Cantor, J. (1998). Children’s attraction to violent television programming. In J. H. Goldstein (Ed.), Why we watch: The attractions of violent entertainment (pp. 116–143). New York, NY: Oxford University Press.

Cantor, J. (2004). “I’ll never have a clown in my house”: Why movie horror lives on. Poetics Today, 25(2), 283–304.

Cantor, J. (2009). Fright reactions to mass media. In J. Bryant & M. B. Oliver (Eds.), Media effects: Advances in theory and research (3rd ed., pp. 287–303). Hillsdale, NJ: Lawrence Erlbaum.

Cantor, J., Byrne, S., Moyer-Gusé, E., & Riddle, K. (2010). Descriptions of media-induced fright reactions in a sample of US elementary school children. Journal of Children and Media, 4, 1–17.

Cantor, J., & Nathanson, A. I. (1997). Predictors of children’s interest in violent television programs. Journal of Broadcasting and Electronic Media, 41, 155–167.


Cantor, J., Wilson, B. J., & Hoffner, C. (1986). Emotional responses to a televised nuclear holocaust film. Communication Research, 13, 257– 277.

Carlson, M., Marcus-Newhall, A., & Miller, N. (1990). Effects of situational aggression cues: A quantitative review. Journal of Personality and Social Psychology, 58, 622–633.

Carnagey, N. L., & Anderson, C. A. (2005). The effects of reward and punishment in violent videogames on aggressive affect, cognition, and behavior. Psychological Science, 16, 882–889.

Carnagey, N. L., Anderson, C. A., & Bushman, B. J. (2007). The effect of video game violence on physiological desensitization to real-life violence. Journal of Experimental Social Psychology, 43, 489–496.

Carré, J. M., McCormick, C. M., & Hariri, A. R. (2011). The social neuroendocrinology of human aggression. Psychoneuroendocrinology, 36(7), 935–944.

Centers for Disease Control and Prevention. (2006). Understanding youth violence (Fact sheet). Retrieved from res/ YVFactSheet.pdf

Centers for Disease Control and Prevention. (2010). Youth violence. Retrieved from datasheet-a.pdf

Centers for Disease Control and Prevention. (2011). Suicide prevention. Retrieved from

Children’s Defense Fund. (2012). Protect children, not guns 2012. Retrieved from publications/data/protect-children-not-guns-2012.pdf

Christensen, P. N., & Wood, W. (2007). Effects of media violence on viewers’ aggression in unconstrained social situations. In R. W. Preiss, B. M. Gayle, N. Burrell, M. Allen, & J. Bryant (Eds.), Mass media effects research: Advances through meta-analysis (pp. 145–168). Mahwah, NJ: Lawrence Erlbaum.

Cline, V. B., Croft, R. G., & Courrier, S. (1973). Desensitization of children to television violence. Journal of Personality and Social Psychology, 35, 450–458.

Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: Lawrence Erlbaum.

Cohen, J. (1999). Favorite characters of teenage viewers of Israeli serials.


Journal of Broadcasting and Electronic Media, 43, 327–345. Collins, W. A. (1973). Effect of temporal separation between motivation,

aggression, and consequences: A developmental study. Developmental Psychology, 8, 215–221.

Collins, W. A. (1975). The developing child as viewer. Journal of Communication, 25, 35–44.

Collins-Standley, T., Gan, S., Yu, H. J., & Zillmann, D. (1996). Choice of romantic, violent, and scary fairy-tale books by preschool girls and boys. Child Study Journal, 26, 279–302.

Common Sense Media/Center for American Progress (2013, January 10). National survey reveals parents’ deep concern about protecting kids from violence. Retrieved from releases/national-survey-reveals-parents-deep-concern-about-protecting- kids-from

Comstock, G., & Powers, J. (2012). Paths from television violence to aggression: Reinterpreting the evidence. In L. J. Shrum (Ed.), The psychology of entertainment media: Blurring the lines between entertainment and persuasion (2nd ed., pp. 305–328). New York, NY: Routledge.

Cooper, H., & Hedges, L. V. (Eds.). (1994). The handbook of research synthesis. New York, NY: Russell Sage.

Coyne, S. M., & Archer, J. (2004). Indirect aggression in the media: A content analysis of British television programs. Aggressive Behavior, 30, 254–271.

Coyne, S. M., Archer, J., & Eslea, M. (2006). “We’re not friends anymore!” Unless . . . : The frequency and harmfulness of indirect, relational, and social aggression. Aggressive Behavior, 32, 294–307.

Coyne, S. M., Callister, M., Pruett, T., Nelson, D. A., Stockdale, L., & Wells, B. M. (2011). A mean read: Aggression in adolescent English literature. Journal of Children and Media, 5, 411–425.

Coyne, S. M., Nelson, D. A., Lawton, F., Haslam, S., Rooney, L., Titterington, L., . . . Ogunlaja, L. (2008). The effects of viewing physical and relational aggression in the media: Evidence for a cross-over effect. Journal of Experimental Psychology, 44(6), 1551–1554.

Crick, N. R., Ostrov, J. M., & Werner, N. E. (2006). A longitudinal study of relational aggression, physical aggression, and children’s social- psychological attachment. Journal of Abnormal Child Psychology, 34,


127–138. Davidson, L. E., Rosenberg, M. L., Mercy, J. A., Franklin, J., & Simmons, J.

T. (1989). An epidemiologic study of risk factors in two teenage suicide clusters. Journal of the American Medical Association, 262, 2687– 2692.

Davidson, O. G. (1993). Under fire: The NRA and the battle for gun control. New York, NY: Holt, Rinehart, & Winston.

Diener, E., & Woody, L. W. (1981). TV violence and viewer liking. Communication Research, 8, 281–306.

Dodge, K. A., & Pettit, G. S. (2003). A biopsychosocial model of the development of chronic conduct problems in adolescence. Developmental Psychology, 39(2), 349–371.

Dominick, J. R., & Greenberg, B. S. (1972). Attitudes toward violence: The interaction of television exposure, family attitudes, and social class. In G. A. Comstock & E. A. Rubinstein (Eds.), Television and social behavior: Vol. 3. Television and adolescent aggressiveness (pp. 314–335). Washington, DC: Government Printing Office.

Dorr, A. (1983). No shortcuts to judging reality. In J. Bryant & D. R. Anderson (Eds.), Children’s understanding of television: Research on attention and comprehension (pp. 199–220). New York, NY: Academic Press.

Drabman, R. S., & Thomas, M. H. (1974). Does media violence increase children’s toleration of real-life aggression? Developmental Psychology, 10, 418–421.

Dunlop, S. M., More, E., & Romer, D. (2011). Where do youth learn about suicides on the Internet, and what influence does this have on suicidal ideation? Journal of Child Psychology and Psychiatry, 52(10), 1073– 1080.

Engelhardt, C. R., Bartholow, B. D., Kerr, G. T., & Bushman, B. J. (2011). This is your brain on violent video games: Neural desensitization to violence predicts increased aggression following violent video game exposure. Journal of Experimental Social Psychology, 47, 1033–1036.

Eron, L. D., Huesmann, L. R., Lefkowitz, M. M., & Walder, L. O. (1972). Does television violence cause aggression? American Psychologist, 27, 253–263.

Etzerdorfer, E., Voracek, M., & Sonneck, G. (2004). A dose-response relationship between imitational suicides and newspaper distribution. Archives of Suicide Research: Official Journal of the International


Academy for Suicide Research, 8(2), 137–145. Faiola, A. (2004, August 9). Youth violence has Japan struggling for

answers: 11-year-old’s killing of classmate puts spotlight on sudden acts of rage. Washington Post, p. A01. Retrieved from 2004Aug8.html

Farah, M. M., Simon, H. K., & Kellermann, A. L. (1999). Firearms in the home: Parental perceptions. Pediatrics, 104, 1059–1063.

Farr, J. (2012, July 21). When movie violence helps inspire real violence, isn’t it time to tone it down? Huff Post Entertainment. Retrieved from inspi_b_1692208.html

Fenigstein, A. (1979). Does aggression cause a preference for viewing media violence? Journal of Personality and Social Psychology, 37, 2307–2317.

Ferguson, C. J., & Kilburn, J. (2009). The public health risks of media violence: A meta-analytic review. Journal of Pediatrics, 154(5), 759– 763.

Ferguson, C. J., & Kilburn, J. (2010). Much ado about nothing: The misestimation and overinterpretation of violent video game effects in Eastern and Western nations: Comment on Anderson et al. (2010). Psychological Bulletin, 136(2), 174–178.

Filotas, D. Y. (1993). Adolescents’ rape attitudes: Effectiveness of rape prevention in high school classrooms. Unpublished master’s thesis, University of California, Santa Barbara.

Fisch, S. M., & Truglio, R. T. (2001). “G” is for growing: Thirty years of research on children and Sesame Street. Mahwah, NJ: Lawrence Erlbaum.

Fisher, A. (2011). Processing of perceptual information is more robust than processing of conceptual information in preschool-age children: Evidence from costs of switching. Cognition, 119, 253–264.

Fowles, J. (1999). The case for television violence. Thousand Oaks, CA: Sage.

Freedman, J. L. (2002). Media violence and its effect on aggression: Assessing the scientific evidence. Toronto, Ontario, Canada: University of Toronto Press.

Friedrich, L. K., & Stein, A. H. (1973). Aggressive and prosocial television programs and the natural behavior of preschool children. Monographs of


the Society for Research in Child Development, 38(4, Serial No. 151), 63.

Fu, K., & Yip, P. S. (2007). Long-term impact of celebrity suicide on suicidal ideation: Results from a population-based study. Journal of Epidemiology and Community Health, 61(6), 540–546.

Funk, J. B., Buchman, D. D., & Germann, J. N. (2000). Preference for violent electronic games, self-concept, and gender differences in young children. American Journal of Orthopsychiatry, 70, 233–241.

Geen, R. G. (1994). Television and aggression: Recent developments in research and theory. In D. Zillmann, J. Bryant, & A. C. Huston (Eds.), Media, children, and the family: Social, scientific, psychodynamic, and clinical perspectives (pp. 151–162). Hillsdale, NJ: Lawrence Erlbaum.

Gentile, D. A., Coyne, S., & Walsh, D. A. (2011). Media violence, physical aggression, and relational aggression in school age children: A short-term longitudinal study. Aggressive Behavior, 37, 193–206.

Gerbner, G., & Gross, L. (1976). Living with television: The violence profile. Journal of Communication, 26, 172–199.

Gerbner, G., Gross, L., Morgan, M., & Signorielli, N. (1980). The “mainstreaming” of America: Violence profile No. 11. Journal of Communication, 30(3), 10–29.

Gerbner, G., Gross, L., Morgan, M., & Signorielli, N. (1994). Growing up with television: The cultivation perspective. In J. Bryant & D. Zillmann (Eds.), Media effects: Advances in theory and research (pp. 17–41). Hillsdale, NJ: Lawrence Erlbaum.

Gerbner, G., Signorielli, N., Morgan, M., & Jackson-Beeck, M. (1979). The demonstration of power: Violence profile No. 10. Journal of Communication, 29, 177–196.

Gibbons, J., Anderson, D. R., Smith, R., Field, D. E., & Fischer, C. (1986). Young children’s recall and reconstruction of audio and audiovisual narratives. Child Development, 57, 1014–1023.

Glascock, J. (2008). Direct and indirect aggression on prime-time network television. Journal of Broadcasting and Electronic Media, 52, 268–281.

Goldstein, J. (1999). The attraction of violent entertainment. Media Psychology, 1, 271–282.

Gould, M. S., Wallenstein, S., Kleinman, M. H., O’Carroll, P., & Mercy, J. (1990). Suicide cluster: An examination of age-specific effects. American Journal of Public Health, 80, 211–212.

Greenberg, B. S., & Gordon, T. F. (1972). Perceptions of violence in


television programs: Critics and the public. In G. A. Comstock & E. A. Rubinstein (Eds.), Television and social behavior: Vol. 1. Media content and control (pp. 244–258). Washington, DC: Government Printing Office.

Groebel, J. (2001). Media violence in cross-cultural perspective: A global study on children’s media behaviors and some educational implications. In D. G. Singer & J. L. Singer (Eds.), Handbook of children and the media (pp. 255–268). Thousand Oaks, CA: Sage.

Gross, K., & Aday, S. (2003). The scary world in your living room and neighborhood: Using local broadcast news, neighborhood crime rates, and personal experience to test agenda setting and cultivation. Journal of Communication, 53, 411–426.

Grossman, D. C., Reay, D. T., & Baker, S. A. (1999). Self-inflicted and unintentional firearm injuries among children and adolescents: The source of firearms. Archives of Pediatrics and Adolescent Medicine, 153, 875–878.

Gunter, B. (2008). Media violence: Is there a case for causality? American Behavioral Scientist, 51(8), 1061–1122.

Gunter, B., & Furnham, A. (1984). Perceptions of television violence: Effects of programme genre and type of violence on viewers’ judgements of violent portrayals. British Journal of Social Psychology, 23, 155– 164.

Haidt, J., McCauley, C., & Rozin P. (1994). Individual differences in sensitivity to disgust: A scale sampling seven domains of disgust elicitors. Personality and Individual Differences, 16, 701–713.

Hamilton, J. T. (1998). Channeling violence: The economic market for violent television programming. Princeton, NJ: Princeton University Press.

Hanratty, M. A., O’Neal, E., & Sulzer, J. L. (1972). The effect of frustration upon imitation of aggression. Journal of Personality and Social Psychology, 21, 30–34.

Harrison, K., & Cantor, J. (1999). Tales from the screen: Enduring fright reactions to scary media. Media Psychology, 1(2), 97–116.

Hawkins, R. P., & Pingree, S. (1980). Some processes in the cultivation effect. Communication Research, 7, 193–226.

Hawkins, R. P., & Pingree, S. (1981). Uniform messages and habitual viewing: Unnecessary assumptions in social reality effects. Human Communication Research, 7, 291–301.


Hayes, J. (2007, January 19). Films and TV up the ante on graphic torture scenes. Pittsburgh Post-Gazette. Retrieved from torture-scenes-468338/

Hearold, S. (1986). A synthesis of 1045 effects of television on social behavior. In F. Comstock (Ed.), Public communication and behavior (Vol. 1, pp. 65–133). New York, NY: Academic Press.

Hicks, D. J. (1965). Imitation and retention of film-mediated aggressive peer and models. Journal of Personality and Social Psychology, 2, 97– 100.

Hirsch, P. (1980). The “scary world” of the nonviewer and other anomalies: A reanalysis of Gerbner et al.’s findings of cultivation analysis (Part I). Communication Research, 7, 403–456.

Hoffner, C. (1996). Children’s wishful identification and parasocial interaction with favorite television characters. Journal of Broadcasting and Electronic Media, 40, 389–402.

Hoffner, C., & Buchanan, M. (2005). Young adults’ wishful identification with television characters: The role of perceived similarity and character attributes. Media Psychology, 7(4), 325–351.

Hoffner, C., & Cantor, J. (1985). Developmental differences in responses to a television character’s appearance and behavior. Developmental Psychology, 21, 1065–1074.

Hogben, M. (1998). Factors moderating the effect of televised aggression on viewer behavior. Communication Research, 25, 220–247.

Huesmann, L. R. (1986). Psychological processes promoting the relation between exposure to media violence and aggressive behavior by the viewer. Journal of Social Issues, 42,125–139.

Huesmann, L. R. (1988). An information processing model for the development of aggression. Aggressive Behavior, 14, 13–24.

Huesmann, L. R. (1998). The role of social information processing and cognitive schemas in the acquisition and maintenance of habitual aggressive behavior. In R. G. Geen & E. Donnerstein (Eds.), Human aggression: Theories, research, and implications for social policy (pp. 1120–1134). San Diego, CA: Academic Press.

Huesmann, L. R. (2007). The impact of electronic media violence: Scientific theory and research. Journal of Adolescent Health, 41(6), S6– S13.

Huesmann, L. R. (2010). Nailing the coffin shut on doubts that violent video


games stimulate aggression: Comment on Anderson et al. (2010). Psychological Bulletin, 136(2), 179–181.

Huesmann, L. R., Dubow, E. F., & Yang, G. (2013). Why it is hard to believe that media violence causes aggression. In K. E. Dill (Ed.), The Oxford Handbook of Media Psychology (pp. 159–171). New York, NY: Oxford University Press.

Huesmann, L. R., & Eron, L. D. (1986a). The development of aggression in American children as a consequence of television violence viewing. In L. R. Huesmann & L. D. Eron (Eds.), Television and the aggressive child: A cross national comparison (pp. 45–80). Hillsdale, NJ: Lawrence Erlbaum.

Huesmann, L. R., & Eron, L. D. (1986b). The development of aggression in children of different cultures: Psychological processes and exposure to violence. In L. R. Huesmann & L. D. Eron (Eds.), Television and the aggressive child: A cross national comparison (pp. 1–27). Hillsdale, NJ: Lawrence Erlbaum.

Huesmann, L. R., Eron, L. D., Klein, R., Brice, P., & Fischer, P. (1983). Mitigating the imitation of aggressive behaviors by changing children’s attitudes about media violence. Journal of Personality and Social Psychology, 44, 899–910.

Huesmann, L. R., Eron, L. D., Lefkowitz, M. M., & Walder, L. O. (1984). Stability of aggression over time and generations. Developmental Psychology, 20, 1120–1134.

Huesmann, L. R., Lagerspetz, K., & Eron, L. D. (1984). Intervening variables in the TV violence-aggression relation: Evidence from two countries. Developmental Psychology, 20, 746–775.

Huesmann, L. R., & Miller, L. S. (1994). Long-term effects of repeated exposure to media violence in childhood. In L. R. Huesmann (Ed.), Aggressive behavior: Current perspectives (pp. 153–186). New York, NY: Plenum.

Huesmann, L. R., Moise-Titus, J., Podolski, C., & Eron, L. D. (2003). Longitudinal relations between children’s exposure to TV violence and their aggressive and violent behavior in young adulthood: 1977–1992. Developmental Psychology, 39, 2001–2021.

Hughes, M. (1980). The fruits of cultivation analysis: A re-examination of television in fear of victimization, alienation, and approval of violence. Public Opinion Quarterly, 44, 287–302.

Hunnicutt, G., & Andrews, K. H. (2009). Tragic narratives in popular


culture: Depictions of homicide in rap music. Sociological Forum, 24(3), 611–630.

Huston, A. C., Donnerstein, E., Fairchild, H. H., Feshbach, N. D., Katz, P. A., Murray, J. P., . . . Zuckerman, D. (1992). Big world, small screen: The role of television in American society. Lincoln: University of Nebraska Press.

Insel, B. J., & Gould, M. S. (2008). Impact of modeling on adolescent suicidal behavior. Psychiatric Clinics of North America, 31(2), 293– 316.

Iwao, S., Pool, I., & Hagiwara, S. (1981). Japanese and U.S. media: Some cross-cultural insights into TV violence. Journal of Communication, 31(2), 29–36.

Jackman, G. A., Farah, M. M., Kellermann, A. L., & Simon, H. K. (2001). Seeing is believing: What do boys do when they find a real gun? Pediatrics, 107, 1247–1250.

Jamieson, P. E., & Romer, D. (2011). Trends in explicit portrayal of suicidal behavior in popular U.S. movies, 1950–2006. Archives of Suicide Research, 15(3), 277–289.

Jamieson, P. E., Romer, D., & Jamieson, K. H. (2006). Do films about mentally disturbed characters promote ineffective coping in vulnerable youth? Journal of Adolescence, 29, 749–760.

Jayson, S. (2012, August 8). Studies show cyberbullying concerns have been overstated. USA Today. Retrieved from cyberbullying-prevalent/56724200/1

Jeong, S., Cho, H., & Hwang, Y. (2012). Media literacy interventions: A meta-analytic review. Journal of Communication, 62(3), 454–472.

Jo, E., & Berkowitz, L. (1994). A priming effect analysis of media influences: An update. In J. Bryant & D. Zillmann (Eds.), Media effects: Advances in theory and research (pp. 43–60). Hillsdale, NJ: Lawrence Erlbaum.

Jobes, D. A., Berman, A. L., O’Carroll, P. W., Eastgard, S., & Knickmeyer, S. (1996). The Kurt Cobain suicide crisis: Perspectives from research, public health, and the news media. Suicide and Life Threatening Behavior, 26, 260–269.

Johnson, R. M., Coyne-Beasley, T., & Runyan, C. W. (2004). Firearm ownership and storage practices, US households, 1992–2002: A systematic review. American Journal of Preventative Medicine, 27(2),


173–182. Johnson, R. M., Miller, M., Vriniotis, M., Azrael, D., & Hemenway, D.

(2006). Are household firearms stored less safely in homes with adolescents? Archives of Pediatrics and Adolescent Medicine, 160, 788–792.

Johnston, D. D. (1995). Adolescents’ motivations for viewing graphic horror. Human Communication Research, 21, 522–552.

Jones, G. (2002). Killing monsters: Our children’s need for fantasy, heroism, and make-believe violence. New York, NY: Basic Books.

Jose, P. E., & Brewer, W. F. (1984). Development of story liking: Character identification, suspense, and outcome resolution. Developmental Psychology, 20, 911–924.

Josephson, W. L. (1987). Television violence and children’s aggression: Testing the priming, social script, and disinhibition predictions. Journal of Personality and Social Psychology, 53, 882–890.

Kellermann, A. L., Rivara, F. P., Rushforth, N. B., Banton, J. G., Reay, D. T., Francisco, J. T., . . . Somes, G. (1993). Gun ownership as a risk factor for homicide in the home. New England Journal of Medicine, 329, 1084– 1091.

Kellermann, A. L., Somes, G., Rivara, F. P., Lee, R. K., & Banton, J. G. (1998). Injuries and deaths due to firearms in the home. Journal of Trauma, Injury Infection and Critical Care, 45, 263–267.

Kendeou, P., Bohn-Gettler, C., White, M. J., & van den Broek, P. (2008). Children’s inference generation across different media. Journal of Research in Reading, 31(3), 259–272.

Klimkiewicz, J. (2007, April 20). The making of an abhorrent icon. Hartford Courant. Retrieved from

Kodaira, S. I. (1998). A review of research on media violence in Japan. In U. Carlsson & C. von Feilitzen (Eds.), Children and media violence (pp. 81–105). Goteborg, Sweden: UNESCO International Clearinghouse on Children and Violence on the Screen.

Koehler, R. (2012, July 25). Good violence, bad violence. Retrieved from

Konijn, E. A., Nije Bijvank, M., & Bushman, B. J. (2007). I wish I were a warrior: The role of wishful identification in the effects of violent video games on aggression in adolescent boys. Developmental Psychology, 43, 1038–1044.


Kopel, D. B. (1993). Japanese gun control. Asia Pacific Law Review, 2(2), 26–52. Retrieved from

Krahe, B., & Moller, I. (2010). Longitudinal effects of media violence on aggression and empathy among German adolescents. Journal of Applied Developmental Psychology, 31, 401–409.

Krahe, B., Moller, I., Huesmann, L. R., Kirwil, L., Felber, J., & Berger, A. (2011). Desensitization to media violence: Links with habitual media violence exposure, aggressive cognitions, and aggressive behavior. Journal of Personality and Social Psychology, 100(4), 630–646.

Krcmar, M., & Cooke, M. C. (2001). Children’s moral reasoning and perceptions of television violence. Journal of Communication, 51, 300– 316.

Krcmar, M., Farrar, K., & McGloin, R. (2011). The effects of video game realism on attention, retention and aggressive outcomes. Computers in Human Behavior, 27(1), 432–439.

Krcmar, M., & Hight, A. (2007). The development of aggressive mental models in young children. Media Psychology, 10, 250–269.

Kuntsche, E., Pickett, W., Overpeck, M., Craig, W., Boyce, W., & deMatos, M. G. (2006). Television viewing and forms of bullying among adolescents from eight countries. Journal of Adolescent Health, 39, 908– 915.

Lazarus, R. S., & Alfert, E. (1964). Short-circuiting of threat by experimentally altering cognitive appraisal. Journal of Abnormal and Social Psychology, 69, 195–205.

Lefkowitz, M. M., Eron, L. D., Walder, L. O., & Huesmann, L. R. (1972). Television violence and child aggression: A follow-up study. In G. A. Comstock & E. A. Rubinstein (Eds.), Television and social behavior: Vol. 3. Television and adolescent aggressiveness (pp. 33–135). Washington, DC: Government Printing Office.

Lichtblau, E. (2013, January 11). Makers of violent video games marshal support to fend off regulation. New York Times, retrieved from video-games-marshal-support-to-fend-off-regulation.html

Liebert, R. M., & Sprafkin, J. (1988). The early window: Effects of television on children and youth. New York, NY: Pergamon.

Lies, E. (2001, June 8). Random violence on the rise in Japan. Retrieved from 412%2c00.html


Linder, J., & Lyle, K. (2011). A content analysis of indirect, verbal, and physical aggression in television programs popular among school-aged girls. American Journal of Media Psychology, 4, 24–42.

Linz, D. G., Donnerstein, E., & Penrod, S. (1984). The effects of multiple exposures to filmed violence against women. Journal of Communication, 34, 130–147.

Linz, D. G., Donnerstein, E., & Penrod, S. (1988). Effects of long-term exposure to violent and sexually degrading depictions of women. Journal of Personality and Social Psychology, 55, 758–768.

Liss, M. B., Reinhardt, L. C., & Fredriksen, S. (1983). TV heroes: The impact of rhetoric and deeds. Journal of Applied Developmental Psychology, 4, 175–187.

Lovaas, O. I. (1961). Effect of exposure to symbolic aggression on aggressive behavior. Child Development, 32, 37–44.

Lowry, B. (1997, September 21). The times poll: TV on decline, but few back U.S. regulation. Los Angeles Times, p. A01.

Luxton, D. D., June, J. D., & Fairall, J. M. (2012). Social media and suicide: A public health perspective. American Journal of Public Health, 102(s2), s195–s200.

Mares, M. L. (2006). Repetition increases children’s comprehension of television content—up to a point. Communication Monographs, 73(2), 216–241.

Mares, M. L., & Acosta, E. E. (2008). Be kind to three-legged dogs: Children’s literal interpretations of TV’s moral lessons. Media Psychology, 11(3), 377–399.

Martin, J. R., Sklar, D. P., & McFeeley, P. (1991). Accidental firearm fatalities among New Mexico children. Annals of Emergency Medicine, 20, 58–61.

Martins, N., & Wilson, B. J. (2012a). Mean on the screen: Social aggression in programs popular with children. Journal of Communication, 62, 991-1009.

Martins, N., & Wilson, B. J. (2012b). Social aggression on television and its relationship to children’s aggression in the classroom. Human Communication Research, 38, 48–71.

McIntyre, J. J., & Teevan, J. J., Jr. (1972). Television violence and deviant behavior. In G. A. Comstock & E. A. Rubinstein (Eds.), Television and social behavior: Vol. 3. Television and adolescent aggressiveness (pp. 383–435). Washington, DC: Government Printing Office.


McLeod, J. M., Atkin, C. K., & Chaffee, S. H. (1972a). Adolescents, parents, and television use: Adolescent self-report measures from Maryland and Wisconsin samples. In G. A. Comstock & E. A. Rubinstein (Eds.), Television and social behavior: Vol. 3. Television and adolescent aggressiveness (pp. 173–238). Washington, DC: Government Printing Office.

McLeod, J. M., Atkin, C. K., & Chaffee, S. H. (1972b). Self-report and other-report measures from the Wisconsin sample. In G. A. Comstock & E. A. Rubinstein (Eds.), Television and social behavior: Vol. 3. Television and adolescent aggressiveness (pp. 239–313). Washington, DC: Government Printing Office.

Milavsky, J. R., Kessler, R., Stipp, H. H., & Rubens, W. S. (1982). Television and aggression: A panel study. New York, NY: Academic Press.

Miller, M., Lippmann, S. J., Azrael, D., & Hemenway, D. (2007). Household firearm ownership and rates of suicide across the 50 United States. Journal of Trauma – Injury, Infection, and Critical Care, 62(4), 1029–1034.

Molitor, F., & Hirsch, K. W. (1994). Children’s toleration of real-life aggression after exposure to media violence: A replication of the Drabman and Thomas studies. Child Study Journal, 24, 191–207.

Moretti, M. M., Osbuth, C. L., Odgers, P., & Reebye, P. (2006). Exposure to maternal vs. paternal partner violence, PTSD, and aggression in adolescent girls and boys. Aggressive Behavior, 4, 385–395.

Morgan, M. (2009). Cultivation analysis and media effects. In R. Nabi & M. Oliver (Eds.), Handbook of media effects (pp. 69–82). Thousand Oaks, CA: Sage.

Morgan, M., Shanahan, J., & Signorielli, N. (2009). Growing up with television: Cultivation processes. In J. Bryant & M. Oliver (Eds.), Media effects: Advances in theory and research (3rd ed., pp. 34–49). Hillsdale, NJ: Erlbaum.

Mullen, B. (1989). Advanced basic meta analysis. Hillsdale, NJ: Lawrence Erlbaum.

Mullin, C. R., & Linz, D. (1995). Desensitization and resensitization to violence against women: Effects of exposure to sexually violent films on judgments of domestic violence victims. Journal of Personality and Social Psychology, 69, 449–459.

Murray, J. P. (2008). Media violence: The effects are both real and strong.


American Behavioral Scientist, 51(8), 1212–1230. Naisbitt, J., Naisbitt, N., & Philips, D. (1999). High tech, high touch:

Technology and our search for meaning. New York, NY: Broadway Books.

Nansel, T. R., Overpeck, M., Pilla, R. S., Ruan, W. J., Simons-Morton, B., & Scheidt, P. (2001). Bullying behaviors among US youth: Prevalence and association with psychosocial adjustment. Journal of the American Medical Association, 285, 2094–2100.

New poll finds escalating violence in children’s TV now a crisis for parents. (2005). Retrieved from

Nishiyama, G. (2007, November 26). Japan tightens gun control after spate of shootings. Reuters. Retrieved from

Ogles, R. M., & Hoffner, C. (1987). Film violence and perceptions of crime: The cultivation effect. In M. L. McLaughlin (Ed.), Communication yearbook (Vol. 10, pp. 384–394). Newbury Park, CA: Sage.

Okoro, C. A., Nelson, D. E., Mercy, J. A., Balluz, L. S., Crosby, A. E., & Mokdad, A. H. (2005). Prevalence of household firearms and firearm- storage practices in the 50 states and the District of Columbia: Findings from the behavioral risk factor surveillance system, 2002. Pediatrics, 116(3), e370–e376.

Olatunji, B. O., Cisler, J. M., & Deacon, B. J. (2010). Efficacy of cognitive behavioral therapy for anxiety disorders: A review of meta-analytic findings. Psychiatric Clinics of North America, 33(3), 557–577.

Oliver, M. B. (2000). The respondent gender gap. In D. Zillmann & P. Vorderer (Eds.), Media entertainment: The psychology of its appeal (pp. 215–234). Mahwah, NJ: Lawrence Erlbaum.

Ostrov, J. M., Gentile, D. A., & Crick, N. R. (2006). Media exposure, aggression and prosocial behavior during early childhood: A longitudinal study. Social Development, 15, 612–627.

Ostrov, J. M., & Godleski, S. A. (2010). Toward an integrated gender- linked model of aggression subtypes in early and middle childhood. Psychological Review, 117(1), 233–242.

Otto, M. W., Henin, A., Hirshfeld-Becker, D. R., Pollack, M. H., Biederman, J., & Rosenbaum, J. F. (2007). Posttraumatic stress disorder symptoms following media exposure to tragic events: Impact of 9/11 on children at risk for anxiety disorders. Journal of Anxiety Disorders, 21,


888–902. Paik, H. J., & Comstock, G. (1994). The effects of television violence on

antisocial behavior: A meta-analysis. Communication Research, 21, 516–546.

Perse, E. M. (1990). Cultivation and involvement with local television news. In N. Signorielli & M. Morgan (Eds.), Cultivation analysis: New directions in media effects research (pp. 51–69). Newbury Park, CA: Sage.

Pfefferbaum, B., Seale, T. W., McDonald, N. B., Brandt, E. N., Jr., Rainwater, S. M., Maynard, B. T., . . . Miller, P. D. (2000). Posttraumatic stress two years after the Oklahoma City bombing in youths geographically distant from the explosion. Psychiatry, 63, 358–370.

Phillips, D. P., & Carstensen, L. L. (1986). Clustering of teenage suicides after television-news stories about suicide. New England Journal of Medicine, 315(11), 685–689.

Phillips, D. P., Carstensen, L. L., & Paight, D. J. (1989). Effects of mass media news stories on suicide, with new evidence on the role of story content. In C. R. Pfeffer (Ed.), Suicide among youth: Perspectives on risk and prevention (pp. 101–116). Washington, DC: American Psychiatric Press.

Pirkis, J., & Nordentoft, M. (2011). Media influences on suicide and attempted suicide. In R. C. O’Connor, S. Platt, & J. Gordon (Eds.), International handbook of suicide prevention: Research, policy and practice. Malden, MA: John Wiley.

Pool, B. (1991, November 3). Screen violence would stop if it didn’t sell tickets, filmmakers say. Los Angeles Times, pp. B1, B6.

Potter, W. J. (1993). Cultivation theory and research: A conceptual critique. Human Communication Research, 19, 564–601.

Report of the Media Violence Commission. (2012). Aggressive Behavior, 38(5), 335–341.

Resnick, M. D., Bearman, P. S., Blum, R. W., Bauman, K. E., Harris, K. M., Jones, J., . . . Udry, J. R. (1997). Protecting adolescents from harm: Findings from the National Longitudinal Study on Adolescent Health. Journal of the American Medical Association, 278, 823–832.

Riddle, K. (2010). Always on my mind: Exploring how frequent, recent, and vivid television portrayals are used in the formation of social reality judgments. Media Psychology, 13, 155–179.

Riddle, K., Cantor, J., Byrne, S., & Moyer-Gusé, E. (2012). “People killing


people on the news”: Young children’s descriptions of frightening television news content. Communication Quarterly, 60(2), 278–294.

Rigby, K. (2003). Consequences of bullying in schools. Canadian Journal of Psychiatry, 48, 583–590.

Robinson, J. P., & Bachman, J. G. (1972). Television viewing habits and aggression. In G. A. Comstock & E. A. Rubinstein (Eds.), Television and social behavior: Vol. 3. Television and adolescent aggressiveness (pp. 173–238). Washington, DC: Government Printing Office.

Romer, D., Jamieson, K. H., & Aday, S. (2003). Television news and the cultivation of fear of crime. Journal of Communication, 53, 88–104.

Romer, D., Jamieson, P. E., & Jamieson, K. H. (2006). Are news reports of suicide contagious? A stringent test in six U.S. cities. Journal of Communication, 56, 253–270.

Rosenberg, M. L., Mercy, J. A., & Houk, V. N. (1991). Guns and adolescent suicides. Journal of the American Medical Association, 266, 3030.

Roskos-Ewoldsen, D. R., Klinger, M. R., & Roskos-Ewoldsen, B. (2007). Media priming: A meta-analysis. In R. W. Preiss, B. M. Gayle, N. Burrell, M. Allen, & J. Bryant (Eds.), Mass media effects research: Advances through meta-analysis (pp. 53–80). New York, NY: Routledge.

Roskos-Ewoldsen, D. R., Roskos-Ewoldsen, B. B., & Carpentier, F. D. (2009). Media priming: An updated synthesis. In J. Bryant & M. B. Oliver (Eds.), Media effects: Advances in theory and research (pp. 74– 93). New York, NY: Routledge.

Rothenberg, M. B. (1975). Effect of television violence on children and youth. Journal of the American Medical Association, 234, 1043–1046.

Sargent, J. D., Heatherton, T. F., Ahrens, M. B., Dalton, M. A., Tickle, J. J., & Beach, M. L. (2002). Adolescent exposure to extremely violent movies. Journal of Adolescent Health, 31, 449–454.

Savage, J., & Yancey, C. (2008). The effects of media violence exposure on criminal aggression: A meta-analysis. Criminal Justice and Behavior, 35(6), 772–791.

Savitsky, J. C., Rogers, R. W., Izard, C. E., & Liebert, R. M. (1971). Role of frustration and anger in the imitation of filmed aggression against a human victim. Psychological Reports, 29, 807–810.

Scharrer, E. (2005). Hypermasculinity, aggression, and television violence: An experiment. Media Psychology, 7, 353–376.

Schmitt, K. L., Anderson, D. R., & Collins, P. A. (1999). Form and content:


Looking at visual features of television. Developmental Psychology, 35, 1156–1167.

Selah-Shayovits, R. (2006). Adolescent preferences for violence in television shows and music video clips. International Journal of Adolescence and Youth, 13, 99–112.

Servin, A., Bohlin, G., & Berlin, L. (1999). Sex differences in 1-, 3-, and 5- year-olds’ toy-choice in a structured play-session. Scandinavian Journal of Psychology, 40, 43–48.

Shanahan, J., & Morgan, M. (1999). Television and its viewers: Cultivation theory and research. London, UK: Cambridge University Press.

Shrum, L. J. (2001). Processing strategy moderates the cultivation effect. Human Communication Research, 27, 94–120.

Shrum, L. J. (2009). Media consumption and perceptions of social reality: Effects and underlying processes. In J. Bryant & M. Oliver (Eds.), Media effects: Advances in theory and research (3rd ed., pp. 50–73). Hillsdale, NJ: Erlbaum.

Shrum, L. J., & Lee, J. (2012). Multiple processes underlying cultivation effects: How cultivation works depends on the types of beliefs being cultivated. In M. Morgan, J. Shanahan, & N. Signorielli (Eds.), The cultivation differential: State of the art research in cultivation theory. New York, NY: Peter Lang.

Signorielli, N. (1990). Television and health: Images and impact. In C. Atkin & L. Wallack (Eds.), Mass communication and public health: Complexities and conflicts (pp. 96–113). Newbury Park, CA: Sage.

Singer, J. L., & Singer, D. G. (1986). Family experiences and television viewing as predictors of children’s imagination, restlessness, and aggression. Journal of Social Issues, 42, 107–124.

Singer, J. L., Singer, D. G., & Rapaczynski, W. (1984). Family patterns and television viewing as predictors of children’s beliefs and aggression. Journal of Communication, 34, 73–89.

Sisask, M., & Varnik, A. (2012). Media roles in suicide prevention: A systematic review. International Journal of Environmental Research and Public Health, 9, 123–138.

Slater, M. D. (2003). Alienation, aggression, and sensation seeking as predictors of adolescent use of violent film, computer, and website content. Journal of Communication, 53, 105–121.

Smith, S. L., & Boyson, A. R. (2002). Violence in music videos: Examining the prevalence and context of physical aggression. Journal of


Communication, 52, 61–83. Smith, S. L., Boyson, A. R., Pieper, K. M., & Wilson, B. J. (2001, May).

Brandishing guns on American television: How often do such weapons appear and in what context? Paper presented at the annual meeting of the International Communication Association, Washington, DC.

Smith, S. L., & Wilson, B. J. (2002). Children’s comprehension of and fright reactions to television news. Media Psychology, 4, 1–26.

Smith, S. L., Wilson, B. J., Kunkel, D., Linz, D., Potter, W. J., Colvin, C., & Donnerstein, E. (1998). Violence in television programming overall: University of California, Santa Barbara study. In National television violence study: Vol. 3 (pp. 5–220). Thousand Oaks, CA: Sage.

Snyder, H. N., & Sickmund, M. (2006). Juvenile offenders and victims: 2006 national report. Washington, DC: U.S. Department of Justice, Office of Juvenile Justice and Delinquency Prevention.

Speisman, J. C., Lazarus, R. S., Davison, L., & Mordkoff, A. M. (1964). Experimental analysis of a film used as a threatening stimulus. Journal of Consulting Psychology, 28, 23–33.

Spencer, T. (2001, January 25). Wrestling death case deliberated. Los Angeles Times. Retrieved from

Spieker, S. J., Campbell, S. B., Vandergrift, N., Pierce, K. M., Caufmann, E., Susman, E. J., & Roisman, G. I. (2012). Relational aggression in middle childhood: Predictors and adolescent outcomes. Social Development, 21(2), 354–375.

Stack, S. (2005). Suicide in the media: A quantitative review of studies based on nonfictional stories. Suicide and Life-Threatening Behavior, 35, 121–133.

Steuer, F. B., Applefield, J. M., & Smith, R. (1971). Televised aggression and interpersonal aggression of preschool children. Journal of Experimental Child Psychology, 11, 442–447.

Subra, B., Muller, D., Begue, L., Bushman, B. J., & Delmas, F. (2010). Automatic effects of alcohol and aggressive cues on aggressive thoughts and behaviors. Personality and Social Psychology Bulletin, 36(8), 1052–1057.

Swahn, M. H., Hammig, B. J., & Ikeda, R. M. (2002). Prevalence of youth access to alcohol or a gun in the home. Injury Prevention, 8, 227–230.

Tamborini, R., & Stiff, J. (1987). Predictors of horror film attendance and appeal: An analysis of the audience for frightening films. Communication


Research, 14, 415–436. Tatum, P. T., Canetto, S. S., & Slater, M. D. (2010). Suicide coverage in

U.S. newspapers following the publication of the media guidelines. Suicide and Life-Threatening Behavior, 40(5), 524–534.

Thomas, M. H., & Drabman, R. S. (1975). Toleration of real life aggression as a function of exposure to televised violence and age of subject. Merrill-Palmer Quarterly, 21, 227–232.

Thomas, M. H., Horton, R. W., Lippincott, E. C., & Drabman, R. S. (1977). Desensitization to portrayals of real-life aggression as a function of exposure to television violence. Journal of Personality and Social Psychology, 35, 450–458.

Thomas, M. H., & Tell, P. M. (1974). Effects of viewing real versus fantasy violence upon interpersonal aggression. Journal of Research in Personality, 8, 153–160.

Thompson, K. T., & Yokota, F. (2004). Violence, sex, and profanity in films: Correlation of movie ratings with context. Medscape General Medicine, 6(3), 3–11.

Toppo, G. (2007). Experts ponder patterns in school shootings. USA Today. Retrieved from schoolshooters_N.htm

Trend, D. (2007). The myth of media violence: A critical introduction. Malden, MA: Blackwell.

Tulving, E., & Thomson, D. M. (1973). Encoding specificity and retrieval processes in episodic memory. Psychological Review, 80, 359–380.

TV parental guidelines. (n.d.). Washington, DC: The TV Parental Guidelines Monitoring Board. Retrieved from

United Nations Office of Drugs and Crime. (2012). United Nations Office of Drugs and Crime homicide statistics (Fact sheet). Retrieved from documents/data-and- analysis/statistics/crime/Homicide_statistics2012.xls

Ursin, H., & Eriksen, H. R. (2001). Sensitization, subjective health complaints, and sustained arousal. Annals of the New York Academy of Sciences, 933, 119–129.

U.S. Department of Health and Human Services, Office of the Surgeon General. (2001). Youth violence: A report of the surgeon general. Retrieved from

U.S. Department of Justice, Federal Bureau of Investigation. (2011).


Uniform Crime Report: Crime in the United States, 2010. Retrieved from in-the-u.s.-2010/2010%20CIUS%20Summary.pdf

Valkenburg, P. M., & Buijzen, M. (2011). Fear responses to media entertainment. In S. L. Calvert & B. J. Wilson (Eds.), The handbook of children, media and development (pp. 334–352). Oxford, UK: Blackwell.

van den Broek, P., Lorch, E. P., & Thurlow, R. (1996). Children’s and adults’ memory for television stories: The role of causal factors, story- grammar categories, and hierarchical level. Child Development, 67, 3010–3028.

Vaughn, M. G., Perron, B. E., Abdon, A., Olate, R., Groom, R., & Wu, L. (2012). Correlates of handgun carrying among adolescents in the United States. Journal of Interpersonal Violence, 27(10), 2003–2021.

Walters, R. H., & Parke, R. D. (1964). Influence of response consequences to a social model on resistance to deviation. Journal of Experimental Child Psychology, 1, 269–280.

Weaver, A.J. (2011). A meta-analytical review of selective exposure to and the enjoyment of media violence. Journal of Broadcast and Electronic Media, 55, 232–250.

Weaver, A. J., Jensen J. D., Martins N., Hurley R., & Wilson, B. J. (2011). Liking violence and action: An examination of gender differences in children’s processing of animated content. Media Psychology, 14, 49–70.

Weaver, A. J., & Kobach, M. J. (2012). The relationship between selective exposure and the enjoyment of television violence. Aggressive Behavior, 38, 175–184.

Weaver, A. J., & Wilson, B. J. (2009). The role of graphic and sanitized violence in the enjoyment of television dramas. Human Communication Research, 35(3), 442–463.

Webb, T., Jenkins, L., Browne, N., Afifi, A. A., & Kraus, J. (2007). Violent entertainment pitched to adolescents: An analysis of PG-13 films. Pediatrics, 119(6), e1219–e1229.

Wilson, B. J., Colvin, C. M., & Smith, S. L. (2002). Engaging in violence on American television: A comparison of child, teen, and adult perpetrators. Journal of Communication, 52(1), 36–60.

Wilson, B. J., Hoffner, C., & Cantor, J. (1987). Children’s perceptions of the effectiveness of techniques to reduce fear from mass media. Journal of Applied Developmental Psychology, 8, 39–52.


Wilson, B. J., Kunkel, D., Linz, D., Potter, W. J., Donnerstein, E., Smith, S. L., . . . Gray, T. (1997). Violence in television programming overall: University of California, Santa Barbara study. In National television violence study (Vol. 1, pp. 3–268). Thousand Oaks, CA: Sage.

Wilson, B. J., Kunkel, D., Linz, D., Potter, W. J., Donnerstein, E., Smith, S. L., . . . Berry, M. (1998). Violence in television programming overall: University of California, Santa Barbara study. In National television violence study (Vol. 2, pp. 3–204). Thousand Oaks, CA: Sage.

Wilson, B. J., Linz, D., Donnerstein, E., & Stipp, H. (1992). The impact of social issue television programming on attitudes towards rape. Human Communication Research, 19, 179–208.

Wilson, B. J., Linz, D., Federman, J., Smith, S., Paul, B., Nathanson, A., . . . Lingsweiler, R. (1999). The Choices and Consequences evaluation: A study of Court TV’s anti-violence curriculum. Santa Barbara: University of California, Santa Barbara, Center for Communication and Social Policy.

Wilson, B. J., Martins, N., & Marske, A. L. (2005). Children’s and parents’ fright reactions to kidnapping stories in the news. Communication Monographs, 72, 46–70.

Wilson, B. J., Smith, S. L., Potter, W. J., Kunkel, D., Linz, D., Colvin, C. M., & Donnerstein, E. (2002). Violence in children’s television programming: Assessing the risks. Journal of Communication, 52(1), 5– 35.

Wotring, C. E., & Greenberg, B. S. (1973). Experiments in televised violence and verbal aggression: Two exploratory studies. Journal of Communication, 23, 446–460.

Wright, J. C., Huston, A. C., Reitz, A. L., & Piemyat, S. (1994). Young children’s perceptions of television reality: Determinants and developmental differences. Developmental Psychology, 30, 229–239.

Xie, G.-X., & Lee, M. (2008). Anticipated violence, arousal, and enjoyment of violent movies: Viewers’ reactions to violent previews based on arousal-seeking tendency. Journal of Social Psychology, 148(3), 277– 292.

Yancey, A. K., Siegel, J. M., & McDaniel, K. L. (2002). Role models, ethnic identity, and health-risk behaviors in urban adolescents. Archives of Pediatrics and Adolescent Medicine, 156, 55–61.

Ybarra, M. L., Diener-West, M., Markow, D., Leaf, P. J., Hamburger, M., & Boxer, P. (2008). Linkages between Internet and other media violence


with seriously violent behavior by youth. Pediatrics, 122(5), 929–937. Yokota, F., & Thompson, K. M. (2000). Violence in G-rated animated films.

Journal of the American Medical Association, 283, 2716–2720. Youth Risk Behavior Surveillance System. (2012). Youth risk behavior

surveillance—United States, 2011. Morbidity and Mortality Weekly Report, Surveillance Summaries, 61(4).

Zillmann, D. (1971). Excitation transfer in communication-mediated aggressive behavior. Journal of Experimental Social Psychology, 7, 419–434.

Zillmann, D. (1991). Television viewing and physiological arousal. In J. Bryant & D. Zillmann (Eds.), Responding to the screen: Reception and reaction processes (pp. 103–133). Hillsdale, NJ: Lawrence Erlbaum.

Zillmann, D. (1998). The psychology of the appeal of portrayals of violence. In J. H. Goldstein (Ed.), Why we watch: The attractions of violent entertainment (pp. 179–211). New York, NY: Oxford University Press.

Zillmann, D., & Wakshlag, J. (1985). Fear of victimization and the appeal of crime drama. In D. Zillmann & J. Bryant (Eds.), Selective exposure to communication (pp. 141–156). Hillsdale, NJ: Lawrence Erlbaum.

Zuckerman, M. (1979). Sensation-seeking: Beyond the optimal level of arousal. Hillsdale, NJ: Lawrence Erlbaum.

Zuckerman, M., & Litle, P. (1986). Personality and curiosity about morbid and sexual events. Personality and Individual Differences, 7, 49–56.



Sex, Sexuality, and the Media

Today’s first base is kissing . . . plus fondling this and that. Second base is oral sex. Third base is going all the way. Home plate is learning each other’s names.

—Tom Wolfe Hooking Up (2001)

Pornography is now our most prominent sex educator.

—Youth services worker as quoted in The Sydney Morning Herald (Ryan, 2012)

[My doctor’s] only gone to one medical school, but if you go online, you can get advice from all over the world.

—Teenager as quoted in TECHsex USA: Youth Sexuality and Reproductive Health in the Digital Age

(Boyar, Levine, & Zensius, 2011, p. 17)

Something’s in the air, and I wouldn’t call it love. Like never before, our kids are being bombarded by images of oversexed, underdressed celebrities who can’t seem to step out of a car without displaying their well-waxed private parts to photographers.

—Lead article, Newsweek, February 12, 2007 (Deveny & Kelley, 2007, p. 40)

By baring a single breast in a slam-dunk publicity stunt of two seconds’ duration, [Janet Jackson] also exposed just how many boobs we have in this country. We owe her thanks for a genuine public service.

—New York Times critic Frank Rich (2004, p. 1)

One erect penis on a U.S. screen is more incendiary than a thousand guns.



—Newsweek critic David Ansen (1999, p. 66)

n 1976, the NBC Standards and Practices Department (the network censors) refused to let writer Dan Wakefield use the word responsible when James, at 15, and his girlfriend were about to have sexual intercourse for the first time and wanted to discuss birth control (Wakefield, 1987). To date, the networks still reject most public

service announcements (PSAs) and advertisements about contraception, fearing that they would offend some unknown population (Strasburger, 2012a). If an occasional ad for a birth control product does make it to the air, it is because of its noncontraceptive properties (e.g., Ortho Tri-Cyclen is usually advertised as a treatment for acne, not as a means of preventing pregnancy).

Sex (the commercial networks seem to be telling us) is good for selling everything from shampoo, office machinery, hotel rooms, and beer to prime- time series and made-for-TV movies, but a product that would prevent the tragedy of teenage pregnancy—condoms—must never darken America’s television screens (Strasburger, 2012a). Other media have become increasingly sexually explicit as well, particularly in the past two decades, without much regard for discussing either contraception or sexually transmitted diseases (STDs). “Sexting” and “sextortion”— terms that were completely unknown a decade ago—now put teenagers at risk. Meanwhile, a certain “raunchiness” has crept into mainstream American media, with four-letter words showing up even on prime-time television (Rice, 2000) and celebrity role models such as Paris Hilton, the Kardashians, and Lindsay Lohan engaging in increasingly outrageous and provocative behavior (Deveny & Kelley, 2007). Only AIDS has begun to threaten the conspiracy of silence about the health consequences of sexual activity and to free up the flow of useful and factual information to teenagers, who need it most.

Why and how has this paradox occurred, and what effect does it have on teenage sexual activity? The amount of sexual suggestiveness in the media has increased dramatically in the past two decades (Kunkel, Eyal, Finnerty, Biely, & Donnerstein, 2005). Although the data are not quite as convincing as those for media violence (see Chapter 4), an increasing number of studies now show that media sex warrants considerable concern (Wright, 2011;


Strasburger 2012a).

In the absence of widespread, effective sex education at home or in schools, television and other media have arguably become the leading source of sex education in the United States today (Ballam & Granello, 2011; J. D. Brown, 2008; Strasburger, 2012a). As one noted researcher observes, “Long before many parents begin to discuss sex with their children, answers to such questions as ‘When is it OK to have sex?’ and ‘With whom does one have sexual relations?’ are provided by messages delivered on television” (Kunkel, Cope, & Biely, 1999, p. 230) (see Figure 5.1). This is a rather sad commentary, considering that American media are arguably the most sexually suggestive and irresponsible in the world. Although other countries may show more nudity, only American media titillate their viewers with countless jokes and innuendoes about all aspects of human sexuality. Yet ironically, while advertisers are using sex to sell virtually everything from hotel rooms to shampoo to drugs for erectile dysfunction, the national networks remain reluctant to air advertisements for birth control products.

The body of research about how children and teenagers learn about sexuality from the media and whether it affects their behavior has increased dramatically in the past five years (Strasburger, Jordan, & Donnerstein, 2012; Wright, 2011; Wright, Malamuth, & Donnerstein, 2012). There are now 18 studies using longitudinal data (some use the same data sets) that potentially allow cause-and-effect conclusions to be drawn (Ashby, Arcari, & Edmonson, 2006; Bersamin, Bourdeau, Fisher, & Grube, 2010; Bersamin et al., 2008; Bleakley, Hennessy, Fishbein, & Jordan, 2008; J. D. Brown & L’Engle, 2009; J. D. Brown, L’Engle, et al., 2006; Chandra et al., 2008; Collins et al., 2004; Delgado, Austin, Rich, & Bickham, 2009; Gottfried, Vaala, Bleakley, Hennessy, & Jordan, 2011; Hennessy, Bleakley, Fishbein, & Jordan, 2009; L’Engle & Jackson, 2008; Martino et al., 2006; Martino, Collins, Kanouse, Elliott, & Berry, 2005; O’Hara, Gibbons, Gerrard, Li, & Sargent, 2012; Peter & Valkenburg, 2008; Wingood et al., 2003; Ybarra, Mitchell, Hamburger, Diener-West, & Leaf, 2011), and virtually all of them show a significant impact of sexual content in the media on adolescents’ sexual behavior (Wright, 2011). In addition, dozens of older studies document how the media can shape children’s and adolescents’ beliefs and attitudes about sex and sexuality (J. D. Brown & Strasburger, 2007; Strasburger, 2012a; Strasburger & Council on Communications and Media, 2010; Wright et al., 2012). Nearly all of the studies deal with traditional media; only a few very recent studies have examined the impact of new


technology on sexual attitudes and behavior.

Figure 5.1

SOURCE: Jeff Stahler, Newspaper Enterprise Association, Inc. Reprinted with permission.

Why Is This an Issue? From a public health perspective, sexual content in the media and its impact on adolescent sexual behavior have become an increasingly important issue. Many teenagers actively seek out sexual content in the media (Bleakley, Hennessy, & Fishbein, 2011), and one large international study found that most teenagers are more comfortable finding information about birth control online than they are from their doctors (Bayer HealthCare Pharmaceuticals, 2011). Given the risks involved in early sexual intercourse—pregnancy and sexually transmitted infections (STIs) most notably—one might think that any factor that could affect early sexual activity and prevent harmful consequences would be closely scrutinized. Sadly, that is not the case: Research into sex and the media has lagged behind research on media


violence, obesity, and substance use and remains extremely difficult to do because of lack of funding and difficulty obtaining research approval (Strasburger, 2009).

Although the teenage pregnancy rate in 2010 reached an all-time low, the lowest rate in seven decades—34.3 births per 1,000 women 15- to 19- years-old (Hamilton &Ventura, 2012)—the U.S. continues to have the highest teen pregnancy rate in the Western world and one of the highest rates in the entire world (Centers for Disease Control and Prevention [CDC], 2012a; Martinez, Copen, & Abma, 2011) (see Figure 5.2). The U.S. rate is 10 to 15 times higher than the rate in other developed countries (United Nations, 2011). By contrast, the teen birth rate in Canada was 14 births per 1,000 (about one-third the U.S. rate), the rate in Germany was 10, and the rate in Italy was 7 (less than one-quarter the U.S. rate) (United Nations, 2011). In 2009, more than 400,000 teens 15 to 19 years old gave birth, which was 4% of all women in that age group (CDC, 2011a). Most of these were unintended pregnancies (Kaiser Family Foundation, 2011), and the total cost of all unintended pregnancies in women of childbearing age is an estimated $11 billion a year (Monea & Thomas, 2011). In a unique analysis of data from 86,000 women who gave birth in 2006, researchers found that 40% of pregnancies in the U.S. are either unwanted or mistimed (Finer & Kost, 2011). Contrary to popular belief, young adults have more abortions than teenagers do: 57% of all women having abortions are 20 to 29 years old, and only 16% are teenagers (Pazol et al., 2011).

Similarly, rates of teenage sexual activity have leveled off from the early 1990s but remain problematic. Unfortunately, the Youth Risk Behavior Survey (YRBS)—a biennial survey of high school students nearly nationwide—does not give a complete picture of adolescent sexual activity. Only 7 questions on the national survey deal with sex, compared to 32 questions about drugs and 20 about diet and physical activity. Nevertheless, the survey’s large numbers (it samples more than 16,000 students in 9th through 12th grade every two years in 47 different states) and widespread use make it the most widely quoted source of information. According to the CDC’s 2011 Youth Risk Behavior Surveillance survey (CDC, 2012b) (see Table 5.1):

• In 2011, nearly half (47%) of all high school students reported (ever) having had sexual intercourse. This represents a decline from 54% in 1991.

• One-third had had sex in the previous three months. Six percent said


that they had first had sex before age 13. Fifteen percent reported having had four or more sexual partners.

• Condom use at last intercourse had increased since 1991 but plateaued at 61%; birth control pill use had decreased to 20%.

Figure 5.2 U.S. teen births highest of all industrialized countries.


Table 5.1 Sexual Behavior Among U.S. High School Students, 2011 (in percentages) (N = 15,424)


SOURCE: Data from Centers for Disease Control and Prevention (2012b).

Rates of other sexual activities, especially oral sex, are less well investigated. The YRBS, for example, does not ask about oral sex. A large 2002 study that included 10,000 teens 15 to 19 years old found that 55% had had oral sex (Mosher, Chandra, & Jones, 2005). Another older study of 580 students in 9th grade found that 20% had had oral sex (Halpern-Felsher, Cornell, Kropp, & Tschann, 2005). Four more recent studies have been done:

• The 2006–2008 National Survey of Family Growth, which surveyed more than 21,000 teens 15 to 19 years old, found that nearly half reported having had oral sex (Abma, Martinez, & Copen, 2010).

• In a recent study of nearly 14,000 high school students nationwide, two-thirds reported having engaged in oral sex by age 18 (Halpern & Haydon, 2012).

• Less than 10% of older teens report having had oral sex only, apart from sexual intercourse (Chandra, Mosher, Copen, & Sionean, 2011).

• A large 2012 study of nearly 6,500 teenagers and young adults, ages 15 to 24 years, found that about two-thirds had engaged in oral sex at some point in their lives (Copen, Chandra, & Martinez, 2012).

With sexual activity obviously comes the risk of STIs, and teenagers and young adults have a disproportionate percentage of these infections. Of the 18 million STIs diagnosed annually in the U.S., approximately half occur in young people ages 15 to 24 years, even though they represent only 25% of the sexually experienced population (CDC, 2011a).

One might think that with all of these risks to young people’s health, there would be a public health impetus to educate teenagers in an intensive and comprehensive way about sex. In the U.S., however, that has not been the


case (Quindlen, 2009; Strasburger, 2012a). The first eight years of the new millennium were devoted to abstinence-only sex education, which has been shown to be ineffective (Kirby & Laris, 2009; Santelli et al., 2006), except with 12-year-old African American boys in inner-city Philadelphia (Jemmott, Jemmott, & Fong, 2010). Comprehensive sex education does work (Cavazos-Rehg et al., 2012; Kirby & Laris, 2009; Lindberg & Maddow-Zimet, 2012), but it arguably has been marginalized (Lindberg, Santelli, & Singh, 2006). For example, although most of the nearly 2,800 fifteen- to nineteen-year-olds surveyed in the 2006–2008 National Survey of Family Growth reported having received sex education, 30% of females and 38% of males reported having received no information on methods of birth control (Martinez, Abma, & Copen, 2010). A comprehensive survey of sex ed programs in 45 states found that less than half taught 11 comprehensive sex ed topics (Kann, Brener, McManus, & Wechsler, 2012). Ironically, at the same time that abstinence-only sex education was being promulgated, the media were becoming much more sexually suggestive (Strasburger, 2012a). Yet time and again, comprehensive sex education has been shown to be effective: A recent study of 4,691 males and females ages 15 to 26 found that the protective influence extended to when and whether to have sex, contraception, partner selection, and reproductive health outcomes (Lindberg & Maddow-Zimet, 2012). It may even lower teen pregnancy rates, although other factors (e.g., religiosity, abortion policies, sociodemographic characteristics) may play an important role as well (Cavazos-Rehg et al., 2012).

Research shows that parent-child communication can also be effective in preventing early sexual activity among teenagers (Martino, Elliott, Corona, Kanouse, & Schuster, 2008). When surveyed, parents overwhelmingly state that they want their children to receive most of their information about sex from them (Lagus, Bernat, Bearinger, Resnick, & Eisenberg, 2011). But while the majority of parents also favor sex education in schools (Bleakley, Hennessy, & Fishbein, 2006)—90% said it was very or somewhat important in one national survey of parents (National Public Radio, Kaiser Family Foundation, & Kennedy School of Government, 2004)—half of parents of 10- to 12-year-olds have not talked about peer pressure to have sex or how to prevent pregnancy and STIs (Kaiser Family Foundation & Children Now, 1999). Another, more recent study found that more than 40% of teens have had sexual intercourse before any discussion with their parents about birth control (Beckett et al., 2010).

In a separate Kaiser survey, two-thirds of parents said they were very


concerned about their children being exposed to too much inappropriate content in the media, and 55% said that sex in the media was contributing a lot to teenagers’ behavior (Rideout, 2007). As the senior vice president of the Kaiser Family Foundation noted, “The ‘big talk’ isn’t what it used to be. It now needs to be ‘supersized’” (Kaiser Family Foundation & Children Now, 1999). And the media have picked up the slack (J. D. Brown, 2008; Strasburger, 2012a).

Where’s the Sex? In any given society, at any given moment in history, people become sexual the same way they become anything else. Without much reflection, they pick up directions from their social environment. They acquire and assemble meanings, skills, and values from the people around them. Critical choices are often made by going along and drifting. People learn when they are quite young the few things they are expected to be, and continue slowly to accumulate a belief in who they are and ought to be throughout the rest of childhood, adolescence, and adulthood.

—John Gagnon, social science researcher as quoted in Television and Children (E. Roberts, 1983, p. 9)

Traditional Media Television

Prime Time TV. Despite the advent of new technology, prime-time television remains very popular with teenage viewers. What has changed is that TV shows may now be viewed on a laptop, iPad, or cell phone rather than the family’s TV set in the den (Battaglio, 2010; Worden, 2011). About 60% of young people’s TV viewing consists of live TV on a TV set, but the other 40% is now either time-shifted or watched online, on mobile devices, or DVDs (Rideout, Foehr, & Roberts, 2010). In fact, Nielsen reports that TV and video viewing are actually at an all-time high (Nielsen Company, 2011a). Although teenagers watch less TV than adults, they still average nearly 24 hours per week (Nielsen Company, 2011b). Much of what they see contains appreciable sexual content, especially on cable TV and sitcoms. Remarkably, one recent study found that exposure to sexual material is actually highest with TV, followed by music at 69%. In the most


recent Growing Up With Media survey, Ybarra (2011) surveyed more than 1,500 youth 10 to 15 years old and found that the Internet was actually the least common way that young people are exposed to sexual material, at 16% to 25%.

As much as 15 years ago, one-fourth of all verbal interactions on prime- time series watched by teens contained sexual content (Ward, 1995). A subsequent analysis of the sexual messages in the top 15 shows according to Nielsen ratings of teenage viewers found that two-thirds contained sexual talk or behavior, with intercourse depicted in 7% of the programs (Cope- Farrar & Kunkel, 2002). The most comprehensive content analysis of television found that more than 75% of prime-time shows on the major networks contained sexual content, but only 14% of incidents included any mention of the risks or responsibilities of sexual activity or the need for contraception (Kunkel et al., 2005) (see Figure 5.3). This figure rose to 27% for shows depicting or implying intercourse, however (Kunkel et al., 2005). Following the 1997–1998 season, the amount of prime-time sexual content increased from 67% to 77%, but there was only a slight increase in the responsible content figure (Eyal, Kunkel, Biely, & Finnerty, 2007; Kunkel et al., 1999). Movies and sitcoms contain the most sexual content (Kunkel et al., 2005). In fact, talk about sex or sexual behavior can occur as often as 8 to 10 times per hour of prime-time television (Kunkel, Cope, & Colvin, 1996). Unfortunately, only one content analysis exists past 2005 (Parents Television Council, 2010). Not only are these studies expensive and time consuming, but there is very little government or private funding for doing them. In 2010, the Kaiser Family Foundation—which had previously funded the content analyses of sexual material on TV—closed its Media and Health section.

What has been demonstrated so far, however, is that American television largely consists of unrealistic, unhealthy, suggestive sexual behavior or sexual innuendoes (Strasburger & Council on Communications and Media, 2010; Strasburger, 2012a; Van Damme & Van Bauwel, 2013, in press; Wright et al., 2012). It is sex as a casual pastime, a romp in the hay, with little or no consequences. What is meant by content that is sexually suggestive? A few examples will suffice:

• In the late 1990s, a rash of teenage sitcoms appeared on prime-time TV. In Popular, a mother confronts her daughter and stepdaughter: “One of you is thinking of Doing It, if not already Doing It.” In That ’70s Show, one dim teenager asks, “Why cuddle when you can Do


It?” This began the current generation of shows for teenagers that has been termed “Happy Days With Hormones” (K. Tucker, 1999).

• More recently, the MTV series Skins has featured teen girls having sex with each other and teen boys taking erectile dysfunction drugs; CW’s Gossip Girl has featured a threesome; and Showtime’s Shameless has depicted both teenage boys as being sexually active— one of them with a married man (Tomashoff, 2011).

• Children and teens watch a lot of prime-time and adult programming, which similarly has expanded the boundaries of what is permissible. The Good Wife—a Nielsen Top 20 show—featured oral sex in the 2010–2011 season. Showtime series like Spartacus, Californication, and Secret Diary of a Call Girl are filled with sex and nudity (Strauss, 2010).

• One survey actually found that in the 25 highest-rated prime-time series among teenagers, teen female characters were engaged in sexual behavior 47% of the time whereas adult women were engaged in sexual behavior only 29% of the time (Parents Television Council, 2010).

• Both network and cable TV have seemingly become obsessed with genitalia. MTV’s series The Hard Times of RJ Berger began the trend in 2010 with a series about an unpopular high school sophomore who nevertheless has an exceptionally large penis. HBO’s Hung followed with a series about a male prostitute with a similar endowment. And most recently, CBS replaced Charlie Sheen on Two and a Half Men with Ashton Kutcher’s character, who displays his large appendage on the very first show. Meanwhile, female anatomy has not been shortchanged: On CBS’s hit show 2 Broke Girls, waitress Max tries to cool off annoying customers with “That’s the sound of my vagina drying up”; her roommate criticizes her sexual relationships with “What’d you do, shine a bat symbol on your vagina?”; and Whitney’s main character wonders aloud, “When did vaginas get so boring?” (Carter, 2011a; M. E. Williams, 2011).

Figure 5.3 Content analyses of sexual content on TV, 1998–2005.



SOURCE: Kunkel, Eyal, Finnerty, Biely, and Donnerstein (2005). This information was reprinted with permission from the Henry J. Kaiser Family Foundation. The Kaiser Family Foundation, based in Menlo Park, California, is a nonprofit, private operating foundation focusing on the major health care issues facing the nation and is not associated with Kaiser Permanente or Kaiser Industries.

NOTE: Not only is there a lot of sexual content on mainstream American television, but most of it does not deal with the risks and responsibilities of sexual



• Discussion of contraception remains rare among shows popular with teens. Glee never mentions birth control, one of the Gossip Girl characters has had sex with at least eight different men without mention of contraception, and 90210 has had an HIV-positive storyline but rarely mentions safe sex. Only The Secret Life of the American Teenager has discussed both birth control pills and condoms and ends with a PSA directing teens to health care resources (Tuck, 2011).

A distinct minority of TV shows in the past 10 to 15 years have wrestled successfully with sexual responsibility. Beginning with Beverly Hills, 90210, the character of Donna (played by Tori Spelling) maintained her virginity throughout high school, when everyone else was losing theirs. At the end of the decade, during the 1999–2000 season of Dawson’s Creek, the two major characters, Dawson and Joey, remained virgins as they approached their senior year in high school (Jacobs & Shaw, 1999). One research group notes that this is the one encouraging sign in all of the recent content analyses of mainstream television—that shows popular with teens may be more willing to address risks and responsibilities of early sex (Eyal et al., 2007). However, the actual percentage of such shows remains surprisingly low: 14% of any shows with sexual content in 2005, but 23% of shows where teens talk about or engage in sex (Kunkel et al., 2005) (see Figure 5.4). In one interesting twist, the hit show Modern Family featured an episode in which the Dunphy children walk in on their parents having sex. As it turned out, the kids were more comfortable talking about the situation than their parents were (Tomashoff, 2011).

Where the new shows on teen pregnancy fit in is anybody’s guess. MTV’s Teen Mom and 16 and Pregnant have been criticized for glamorizing teen pregnancy, but many organizations are using discussion guides distributed by the National Campaign to Prevent Teen and Unplanned Pregnancy to make the shows positive learning experiences (Hoffman, 2011a). The risk, of course, is analogous to that of other health-related concerns and the media—do these shows make teen pregnancy seem like normative behavior? In one study, a survey of 162 teens associated with Boys & Girls Clubs of America found that 60% had watched 16 and Pregnant, 82% felt that the show helped them understand the challenges of teen pregnancy and parenthood, and only 15% thought it glamorized teen pregnancy (Suellentrop, Brown, & Ortiz, 2010) (see Figure 5.5). However, this was a


very small study, and the bias of social desirability cannot be excluded. A much better, controlled study of 126 teenagers found that viewers of the show had a lower perception of their own pregnancy risk and a greater perception that the benefits of teen pregnancy outweigh the risks (Aubrey, Behm-Morawitz, & Kim, 2013, in press).

MTV is unique among the major networks in having dealt substantively with the issue of teenage abortion, a subject which virtually every other major network—and Hollywood in general—has ignored in years gone by (Navarro, 2007). It aired “No Easy Decision” in 2010 following an episode of 16 and Pregnant and included Dr. Drew Pinsky discussing abortion with several teenagers (Fisher, 2010). In the past few years, The Secret Life of the American Teenager and Make It or Break It on ABC Family have dealt with the topic head on.

Figure 5.4 Percentage of shows with sexual content including references to sexual risks or responsibilities, 1998–2005.

SOURCES: Kunkel, Eyal, Finnerty, Biely, and Donnerstein (2005).

NOTE: Programs that depict teen characters in sexual situations are more likely to include references to the risks and responsibilities of sexual intercourse.

Soap Operas. As with prime-time programming, soap operas have become


even more sexually oriented and sexually explicit since the 1980s. Even as far back as the 1990s, there was an average of 6.6 sexual incidents per hour, sex was visually depicted twice as often as it was talked about, and half of the sexual incidents involved sexual intercourse, usually between unmarried partners (Greenberg & Busselle, 1994; Heintz-Knowles, 1996). Surprisingly, rape was the second most frequently depicted sexual activity, with a total of 71 incidents, or 1.4 per hour. Contraception or “safe sex” was mentioned only 5 times out of 333 sexual incidents. The only mention of AIDS among the 50 episodes studied concerned the risk associated with intravenous drug use, not sex. And there was a single episode where a parent discussed sex with her teenage daughter. British soap operas popular with teenagers have also contained a lot of relational aggression (Coyne & Archer, 2004).

But more recently, soap opera producers have actually been more responsive to national health issues than prime-time producers (Huntemann & Morgan, 2012; Stern, Russell, & Russell, 2005). As one commentary notes, “the once-staple story, popular on shows such as Beverly Hills 90210 and daytime soap operas, of a lone gay male dying of AIDS in a cold hospital room or the young teenager coming out to his homophobic parents has receded” (Huntemann & Morgan, 2012, p. 310). For example, General Hospital (ABC) was the first to feature a character with HIV who at one point discusses with her partner the need to use condoms if they have intercourse. On The Young and the Restless (CBS), a woman decides to get tested for HIV after learning about her husband’s affairs. Internationally, soap operas have been used prosocially to foster healthier attitudes about sex, sexuality, and particularly HIV (Howe, Owen-Smith, & Richardson, 2002; Rivadeneyra & Ward, 2005; Weinberg, 2006).

Figure 5.5 Proportion of teens who agreed or strongly agreed with survey statements.


SOURCE: Suellentrop, Brown, and Ortiz (2010). Reprinted by permission of The National Campaign to Prevent Teen and Unplanned Pregnancy, Washington, DC.

Reality TV. Despite its name, reality TV is anything but real—as any communications student, teacher, or parent well knows (Brenton & Cohen, 2003; Hill, 2005; Murray & Ouellette, 2004). Reality shows seem to appeal to people because they provide both instant gratification and a vicarious sense of self-importance (Kubey, Banerjee, & Donovan, 2012; Nabi, Stitt, Halford, & Finnerty, 2006). But in the early 2000s, reality TV suddenly became immensely popular. In the Nielsen ratings for June 26 to July 2, 2006, for example, 5 of the top 20 shows were reality shows (“Nielsen Ratings,” 2006). Reality shows can vary from talent shows (American Idol, So You Think You Can Dance, The X Factor, America’s Got Talent) to adventure dramas (Survivor, Amazing Race, Fear Factor) to the most common type—sexually oriented shows. These vary from all-out voyeurism (Big Brother, The Real World, Are You Hot?, Jersey Shore) (Bagdasarov et al., 2010) to dating shows such as The Bachelorette and MTV’s Next and Parental Control. The BBC reality show The Baby Borrowers, which premiered in 2007, had parents “donating” their children to teenagers so that they could practice being parents. The announcer opens the show with the


statement, “With the highest rate of teen pregnancy in Europe, Britain’s teenagers are breeding like rabbits” (“Teens ‘Borrow’ Babies,” 2007). NBC tried to duplicate the show in 2008, but it was quickly canceled. Reality shows in the UK also contain significant amounts of relational and verbal aggression (Coyne, Robinson, & Nelson, 2010). Currently, only one U.S. show, Extreme Makeover: Home Edition, fits into the prosocial category.

The overriding messages of many of these shows are that appearance, money, power, and success are paramount and that “you’ve got to be ‘hot’” (Christenson & Ivancin, 2006; Ferris, Smith, Greenberg, & Smith, 2007). They may appeal to viewers’ sense of self-importance and provide “instant gratification” (Kubey et al., 2012). Reality TV has become extremely popular—Jersey Shore has more than 4 million viewers ages 18 to 49—but its popularity may be waning (Carter, 2010b). To date, only three studies have explored the impact of such shows on adolescents and young adults. A study of 197 young adults found that males and viewers who perceived the shows to be real were more likely to share the attitudes displayed in reality dating shows (Ferris et al., 2007). In a study of 334 college students, Zurbriggen and Morgan (2006) found viewing such programming to be correlated with belief in a double standard, the belief that men are sex driven, and the belief that men and women are sexual adversaries. But the researchers also found that those students who tended to be less sexually experienced were actually watching more of the reality dating shows, which may signify the importance of such programs in sexual socialization. And a study of 1,141 preteen and teen girls found that viewing reality shows increased their expectations of respect in dating relationships but also increased their focus on appearance and desire for fame (Ferguson, Salmond, & Modi, 2013).

A Broader Definition of Sex. Sex on television is much more than sexual intercourse or sexual intimacy, however. Children and adolescents can also learn a great deal about sex roles: What does it mean to be a man or a woman? To be gay or straight, bisexual or transgender? What makes someone “cool”? Attractive? Successful? How should one behave around the opposite sex (Signorielli, 2001; Steele, 1999; Strasburger, 2012a)? How should society treat sexual minorities?

Mainstream television is not kind to adolescent girls, for example (Parents Television Council, 2010; Pipher, 1997; Zurbriggen et al., 2010; Smith, Choueiti, Prescott, & Pieper, 2013). The television world is


disproportionately White and male, and female characters are much more likely to be attractive and provocatively dressed than male characters (Zurbriggen et al., 2010). Nearly one-fourth of sexual remarks made on prime-time comedies involve catcalling, leering, ogling, or staring at female characters; another 17% of the sexual remarks concern either body parts or nudity (Lampman et al., 2002). Similarly, a content analysis of workplace situation comedies found an average of 3.3 incidents per episode of joking about women’s sexuality or their bodies, usually accompanied by laugh tracks (Montemurro, 2003). Numerous analyses from the 1990s reported similar findings (Zurbriggen et al., 2010). Whether the new female writers (e.g., 2 Broke Girls, Whitney, New Girl) will be able to change this is or will simply add fuel to the fire is unknown.

On the positive side, the portrayal of sexual minorities has changed dramatically. When Rickie Vasquez came out to his family in a 1994 episode of My So-Called Life, he was bruised and battered, ostracized from his family and living in an abandoned warehouse, and afraid to even utter the word gay. Sixteen years later, it took only four episodes of Glee for Kurt Hummel to tell his father “I’m gay,” to which his father shrugs and responds, “If that’s who you are, there’s nothing I can do about it. And I love you just as much” (Armstrong, 2011). This may be the prime example of Hollywood “leading” society rather than merely “mirroring” it (as producers typically assert). Increased portrayals may lead to a mainstreaming effect on the public’s attitudes toward sexual minorities (Calzo & Ward, 2009; Huntemann & Morgan, 2012).

More than two dozen gay teens are currently or recently depicted on cable and network shows, ranging from Glee to 90210, Shameless, Skins, and Pretty Little Liars (Armstrong, 2011). Unlike the “gay friends” episodes of the 1990s, gay characters on TV now can have children (e.g., Six Feet Under, Modern Family), be professionals (e.g., Project Runway), or even compete on game shows (Survivor, Amazing Race). Compared with even 5 to 10 years ago (Fouts & Inch, 2005), adolescents can now see happy, well-adjusted, professionally successful gay men on TV, although they are still predominantly White (Huntemann & Morgan, 2012) (see Figure 5.6). Glee, with its 14 million viewers, has broken ground not only with its mainstream gay character but with its second-season bullying storyline. Yet gay characters are still absent from most prime-time sitcoms and tween networks, like the Disney Channel and Nickelodeon.



In 1967, the Noxzema girl asked male viewers to “take it off, take it all off.” In 1980, Brooke Shields looked seductively at the camera and purred, “Nothing comes between me and my Calvins” (Calvin Klein jeans). Women’s sexuality has always been exploited by Madison Avenue (see Figure 5.7). But now, seemingly, anything goes: Couples in adjoining bathtubs extol the virtues of erectile dysfunction drugs (L. Carroll, 2010), and Super Bowl ads for Budweiser show a three-armed man grabbing a women’s rear and two men ogling women’s crotches in a yoga class (Bennett, 2003). In mainstream advertising, women are most often depicted as sex objects, as likely to be shown in suggestive clothing (30%), partially clothed (13%), or nude (6%) as they are to be fully clothed (Reichert & Carpenter, 2004; Stankiewicz & Rosselli, 2008). Young teenagers are likely to be exposed to a variety of sexual imagery (Pardun & Forde, 2006) (see Table 5.2).

Figure 5.6 In the past several years, the number of sexual minority characters on network TV has increased.

SOURCE: Gay & Lesbian Alliance Against Defamation (2011). Reprinted with permission.


Figure 5.7 Exploiting women’s sexuality in advertising.

Increasingly, little girls are being sexualized as well (Levin & Kilbourne, 2009). Abercrombie & Fitch advertises thongs bearing the words “Wink Wink” and “Eye Candy” and push-up bras for 7-year-olds (Lo, 2011) (see Figure 5.8). According to one observer, modern advertising often features women’s bodies that have been “dismembered”—just the legs or breasts appear (Kilbourne, 1999) (see Figure 5.9). One by-product of this kind of advertising is that women are subtly taught that their main goal in life is to attract men or serve as sexual prizes. If a woman is successful, how can she possibly say no to a man when he wants sex (J. D. Brown & Steele, 1995)?


Critics have not been blind to these trends; but instead of changing the portrayal of women in advertising, Madison Avenue responded by increasingly exploiting men for their sex appeal, as if that would balance things out (Mager & Helgeson, 2011) (see Figure 5.10).

Table 5.2 Type and Proportion of Sexual Content in Commercials Aired During Programs Most Watched by Early Adolescents (N = 3,250 seventh and eighth graders surveyed and 1,783 commercials examined)

SOURCE: Pardun and Forde (2006). Reprinted with permission.

Movies As a medium, movies are probably less significant than television

because they command much less time from the average teenager and are usually viewed with friends, thus allowing the process of socialization to temper whatever potential effects may exist. If teenagers see two movies per week on their computer or iPad, that still represents only 10% to 15% of the time they spend with all media in an average week. This does not imply that movies are not important, however (Steele, 2002). As many as 80% of all movies later shown on network or cable TV contain sexual content (Kunkel et al., 1999), and that content may be considerably more explicit in the initial theatrical release. There has also been a consistent trend toward the presentation of more sexually suggestive and sexually graphic material in movies (Escobar-Chaves et al., 2005; M. Rich, 2008). At the same time,


there is a considerable gender imbalance in G-rated films: Female characters are outnumbered three to one by male characters (J. Kelly & Smith, 2006).

Figure 5.8 Originally Abercrombie & Fitch marketed these bras for 7- year-olds, but in response to a firestorm of criticism, they changed the age range to 8 to 10 years old. The bras were priced at $24.50, then placed on sale for $18.38.

Figure 5.9 Advertisements featuring women’s “dismembered” bodies.

SOURCE: ©1995 Universal Press Syndicate.


Figure 5.10 Exploiting men’s sexuality in advertising.

SOURCE: ©2008 Jockey International, Inc. All rights reserved; CHIPPENDALES®, THE ULTIMATE GIRLS NIGHT OUT®, and the Cuffs & Collars Trade Dress are registered trademarks owned by Chippendales USA, LLC., and may not be used or reproduced without permission from Chippendales. ©2000–2007 Chippendales USA, LLC. All rights reserved.

Even 25 years ago, more than half of 15- to 16-year-olds surveyed in three Michigan cities had seen the majority of the most popular R-rated movies (Greenberg, Siemicki, Dorfman, Heeter, & Stanley, 1993). Compared with prime-time television, these movies have a frequency of sexual acts or references that is seven times higher, with a much franker depiction than on television (Greenberg, Siemicki, et al., 1993). Moreover, for a society concerned with abstinence, it seems curious that there was an average of eight acts of sexual intercourse between unmarried partners per R-rated film analyzed, or nearly half of all the sexual activity depicted. The ratio of unmarried to married intercourse was 32 to 1 (Greenberg, Siemicki, et al., 1993). As Greenberg (1994) notes, “What television suggests, movies and videos do” (p. 180).

The years 1970 through 1989 represented the era of teenage “sexploitation” films. Hollywood pandered to the adolescent population, presumably because of demographic considerations: Teenagers constitute the largest moviegoing segment of the population. Such movies as Porky’s (I, II, and III), The Last American Virgin, Going All the Way, The First Time, Endless Love, Risky Business, Bachelor Party, and Fast Times at Ridgemont High have dealt with teenage sex. Since the 1980s, virtually


every R-rated teen movie has contained at least one nude scene, and some, such as Fast Times at Ridgemont High and Porky’s, contain up to 15 instances of sexual intercourse (Greenberg, Siemicki, et al., 1993; Strasburger, 2012a).

With the baby boom generation and Generation Y having come of age and produced children and grandchildren of their own, Hollywood seems to continue to target the teen audience. Beginning in 1999, the American Pie series updated Porky’s for the next generation. As one movie critic noted, the film was “pitched to the first generation of male and female adolescents who have been taught, from birth (mostly by MTV), to act as sex objects for each other” (Glieberman, 1999, p. 43). Several American Pie sequels exist. One review cited American Pie 2 as being about “breasts, genitalia, ‘potential’ lesbianism, blue silicone sex toys, crude methods of seduction, ‘the rule of three’ (just watch the movie), a shower of ‘champagne,’ phone sex, tantric sex, and oh yeah . . . superglue” (“American Pie 2,” n.d.). Other researchers feel that the distorted view of romance in contemporary movies popular with teens is at least as problematic as the overt sex (Pardun, 2002). Or that frank portrayals of adolescent sexuality are incredibly rare (C. Kelly, 2005). Sex in many teen-oriented films seems to occur between people who have only recently met (Gunasekera, Chapman, & Campbell, 2005). As in mainstream TV, depictions of sex in popular movies tend to lack safe-sex messages—in one 2005 review of the top 200 movies of the past 20 years, one-third had sex scenes, yet there was only one suggestion of condom use (Gunasekera et al., 2005).

In the past decade, Hollywood films have kept all of their increasingly suggestive and explicit sex and sexuality, and predominantly male orientation, but added a few new twists:

• Sex is still seen most often from the (horny) teenage male’s point of view. In The Girl Next Door (2004), a virginal male’s dreams come true when a former porn star moves in next door. In I Love You, Beth Cooper (2009), a nerdy male valedictorian declares his love during graduation for the hottest girl in school, who then shows up on his doorstep that night. Sex Drive (2008) features a high school senior who steals his brother’s car because a girl whom he’s met online from a neighboring state has agreed to hook up with him. In The Virginity Hit (2010), Matt is the last virgin in his circle of friends, who celebrate having sex for the first time by smoking marijuana on a special bong shaped like a naked woman and discussing all the


details. • From 1950 to 2006, female characters continued to be

underrepresented, yet their depiction in explicit sexual content has increased. A study of 855 of the top-grossing movies over 57 years found that male characters outnumber female characters two to one but female characters are twice as likely to be involved in sex (Bleakley, Jamieson, & Romer, 2012).

• A study of 122 family films (rated G, PG, and PG-13) between 2006 and 2009 found that one in four female characters was depicted in “sexy, tight, or alluring attire,” compared with 4% of male characters (Smith & Choueti, 2010). A similar study found that women in G- rated films wear the same amount of skimpy clothing as women in R- rated films, and 25% of the women were shown with a waist so small that it left “little room for a womb or any other internal organs” (Baird, 2010).

• Judd Apatow has brought new raunch into romantic comedies, with films like The 40 Year Old Virgin (2005), Knocked Up (2007), and Bridesmaids (2011). Both Knocked Up and Juno (2010) assiduously avoided any serious discussion of teenage abortion (see Rickey, 2007). However, Juno was successful in portraying two intelligent, caring, and thoughtful parents of a teenage girl—a distinct rarity in teen films.

A few films have tackled sex and sexuality from a teenage girl’s perspective, most notably Thirteen (2003), Juno, and Easy A (2010). But the abstinence-only movement in the early 2000s seems to have impacted Easy A in an unfavorable way—the movie concerns a 17-year-old girl named Olive who lies about losing her virginity, pretends to have sex with a gay male friend to “protect” his reputation, and turns into a “skank” to impress her peers (Doyle, 2010). So, through the decades, the pattern in Hollywood movies has been to titillate and try to entertain rather than to educate or try to be accurate. This seems unlikely to change in the near future, but what will continue to change are the boundaries of good taste and explicitness.

Print Media Contemporary magazines reflect the same trend seen in television and

movies—a shift away from naive or innocent romantic love in the 1950s and 1960s to increasingly clinical concerns about sexual functioning


(Planned Parenthood Federation of America, 2006; Treise & Gotthoffer, 2001; Walsh-Childers, Gotthoffer, & Lepre, 2002). Content analyses of men’s magazines show a decided concentration on female nudity and male sexual pleasure (Coy & Horvath, 2011). In magazines for females, one of the most dominant themes is being attractive and therefore sexually desirable to men. Looking “hot” and “sexy” and “costuming for seduction” are all important features of the articles, ads, and photographs (Duffy & Gotcher, 1996; Zurbriggen et al., 2010). Both men’s and women’s magazines tend to focus on “great sex” (Menard & Kleinplatz, 2008). In magazines like Glamour and Cosmopolitan, STDs are portrayed as being ubiquitous, dangerous, and disgusting; yet most of the stories promote casual sex for women’s pleasure (Clarke, 2010).

The number of teen magazines has decreased dramatically—only Seventeen still exists in print—but a number of magazines have reemerged online, and most teens read magazines (Case, 2007; D. Roberts, Foehr, & Rideout, 2005; Zurbriggen et al., 2010). In one of the handful of studies of print media that adolescents read, Klein and his colleagues (1993) found that Seventeen, Sports Illustrated, Teen, Time, Ebony, Young Miss, Jet, Newsweek, and Vogue accounted for more than half of all reported reading. Adolescents who read sports or music magazines were more likely to report engaging in risky behaviors. Many teenagers, especially girls, have reported that they rely on magazines as an important source of information about sex, birth control, and health-related issues (Kaiser Family Foundation, 1999; Treise & Gotthoffer, 2001; Wray & Steele, 2002); unfortunately, no studies on the subject have been done in the last decade. A 2004 content analysis of British magazines for teens found that girls’ magazines tended to focus on romance, emotions, and female responsibility for contraception, whereas boys’ magazines were more visually suggestive and assumed that all males were heterosexual (Batchelor, Kitzinger, & Burtney, 2004).

A content analysis of teen magazines found that they devoted an average of two and a half pages per issue to sexual matters (Walsh-Childers, 1997), but the primary focus seems to be on when to lose one’s virginity (Walsh- Childers et al., 2002). Indeed, a content analysis of 627 sex-related feature stories in three U.S. magazines (Seventeen, CosmoGirl!, and Teen) from 2006 to 2008 compared with three Dutch teen girl magazines found that teenage girls’ sexual desires are more prominently depicted in the American magazines (Joshi, Peter, & Valkenburg, 2011). Nearly everything that teenage girls are encouraged to do in a variety of different media is geared toward gaining the attention of boys (Zurbriggen et al., 2010).


Kilbourne (1999) points out the trivialization of sex that occurs in women’s magazines, both in their content and their advertising. For example, one print ad for jeans says, “You can learn more about anatomy after school” and shows a teenage guy groping a girl. According to Kilbourne, the print media give adolescent girls impossibly contradictory messages: Be innocent, but be sexually experienced too. Teen magazines such as Jane (which ended publication in 2007) were filled with articles such as “How Smart Girls Flirt,” “Sex to Write Home About,” “15 Ways Sex Makes You Prettier,” and “Are You Good in Bed?” (Kilbourne, 1999).

In their defense, however, the print media are also far more likely to discuss contraception and advertise birth control products than broadcast media are (Walsh-Childers et al., 2002). As stated above, a 1997 study found that teen magazines devoted an average of two and a half pages per issue to sexual matters, and nearly half (42%) of sexual articles in teen magazines concerned health issues (Walsh-Childers, 1997). In fact, the October 2005 issue of Seventeen featured a very frank, two-page discussion of gynecological health, titled “Vagina 101,” which won a Maggie Award from the Planned Parenthood Federation of America (2006). However, in general, much of the health coverage in teen magazines is in the form of advice columns, and the overarching focus seems to be on deciding when to lose one’s virginity (Huston, Wartella, & Donnerstein, 1998). A number of studies have now included sexual content in magazines in their assessment of whether sexy media lead to earlier intercourse (Bleakley et al., 2008; J. D. Brown, 2008; J. D. Brown, L’Engle, et al., 2006; Hennessy et al., 2009; Ybarra, Mitchell, et al., 2011).

Music and Music Videos

What else can you rap about but money, sex, murder or pimping? There isn’t a whole lot else going on in our world.

—Rapper Ja Rule as quoted in Newsweek (October 9, 2000)

Music. When Little Richard sang, “Good golly, Miss Molly / Sure likes to bawl / When you’re rockin’ and rollin’ / You can’t hear your mama call!” in 1959, he was not singing about a young woman with hay fever and middle ear problems. Nor was the Rolling Stones’ 1960s hit “Let’s Spend the Night Together” about a vacationing family planning to stay at a Motel 6. Of course, suggestive song lyrics did not originate with 1950s rock ‘n’ roll.


From Cole Porter (“The Lady Is a Tramp,” “Let’s Do It”) to 1930s country music singer Jimmy Rodgers (“If you don’t wanna smell my smoke / Don’t monkey with my gun”), classic blues (“Hoochie Coochie Man”), and Mamie Smith (“You can’t keep a good man down”), American songwriters and singers in the 20th century have seemed obsessed with seeing how much they can get away with (Arnett, 2002). Yet there is no question that lyrics have become more provocative and explicit in the past five decades (Hall, West, & Hill, 2011; Herd, 2009) (see Table 5.3).

Music has always been popular with teens, and to a great extent, teen music must be provocative, antiestablishment, and disliked by adults. Rock music (a term hereafter used for all popular teenage music, unless otherwise specified) is an important badge of identity for adolescents and an important activity for them (Council on Communications and Media, 2009; D. F. Roberts & Christenson, 2012). For 15- to 18-year-olds, only television remains a more important medium in terms of hours spent per day (4:22) than music (3:03) (Rideout et al., 2010). By age 18, the two are equal (see Figure 5.11). For many teenagers, music is the “soundtrack” of their lives, and they use it to regulate their moods, comfort themselves, and as a background for socializing, driving, and even doing homework (D. F. Roberts & Christenson, 2012). Of course, as Madison Avenue has nearly completely coopted mainstream rock music (see Table 5.4), adolescents have been pushed farther into rap, alternative rock, and heavy metal music.

Numerous content analyses document what every parent of a teenager already knows—contemporary rock music contains abundant sexual content. An analysis of the 279 most popular songs in 2005 showed that more than one-third contained sexual references, many of which were degrading to women. Rap music had the highest concentration of degrading sexual lyrics (64%), whereas country (45%) and rhythm and blues (28%) had sexual lyrics that were not degrading (Primack, Gold, Schwarz, & Dalton, 2008). A survey of Billboard’s top 100 year-end songs from the end of every decade from 1959 to 2009 found significant increases in sexy lyrics (Hall et al., 2011). The most recent study—an analysis of the lyrics from the 174 songs that made Billboard’s top 10 in 2009—found that 92% had a variety of different sexual messages (see Figure 5.12), with an average of nearly 11 references per song. They ranged from explicit (e.g., “Let’s have some fun / This beat is sick / I want to take a ride on your disco stick” from “Love Game” by Lady Gaga) to fidelity and commitment (e.g., “He knelt down and pulled out a ring / And said ‘Marry Me, Juliette’” from “Love Story” by Taylor Swift). However, an analysis of opera arias and art songs revealed


many similar sexual messages dating back more than 400 years (Hobbs & Gallup, 2011)!

Table 5.3 Sample Rap Music Lyrics

SOURCE: and Ja Rule, Pain Is Love,Def Jam Recordings, New York.

Figure 5.11


SOURCE: Rideout, Foehr, and Roberts (2010). Reprinted with permission.

Table 5.4 Madison Avenue and Mainstream Rock ‘n’ Roll


The real question is, do the lyrics matter? When teenagers are asked about their music, they most often respond that they are just listening to “the beat,” not the lyrics. Yet even if the lyrics are unimportant on a conscious level, it does not exonerate provocative lyrics or dismiss the possibility that teens can learn from them. As one set of experts notes, we do not drive down the highway to look at billboards, but we see them and often read them anyway (D. F. Roberts & Christenson, 2012). If there is “good news” about increasingly explicit lyrics in popular music, it is that teenagers do not typically even know the lyrics to their favorite songs or comprehend their intended meaning. For example, only 10% of 4th graders could correctly interpret a Madonna song, none could correctly interpret a Springsteen song, and nearly half of the college students studied thought that “Born in the USA” was a song of patriotism, not alienation (Greenfield et al., 1987). Of course, interpreting song lyrics can be problematic as well; considerable differences may exist, depending on race, ethnicity, age, experience, and personal values (D. F. Roberts & Christenson, 2012).

Behaviorally, music seems to have some impact but much less than other, visual media. In one interesting experiment, university students were exposed either to four “sexually charged” songs or four nonsexual songs and then asked to rate personal ads in an online dating service. Those exposed to the sexually provocative songs tended to place a much heavier emphasis on sex appeal (Carpentier, Knobloch-Westerwick, & Blumhoff, 2007). A meta-analysis of 23 mostly experimental studies also found support for the notion that music could have a significant impact on various beliefs and actions (Timmerman et al., 2008). In addition, a number of correlational studies have found that misogynistic lyrics increase negative attitudes toward women (Fischer & Greitemeyer, 2006; Hall et al., 2011; Ter Bogt, Engels, Bogers, & Kloosterman, 2010); but as with all correlational studies, it is entirely possible that males with more negative attitudes toward women


seek out more misogynistic music. One study of 711 ninth graders also correlated exposure to sexually degrading lyrics (students averaged 14.7 hours per week with such songs) to a two times greater risk of sexual intercourse by 9th grade (Primack, Douglas, Fine, & Dalton, 2009).

Figure 5.12 Distribution of reproductive themes for 2009 songs as a function of song type.

SOURCE: From Hobbs and Gallup (2011). Reprinted with permission.

Finally, a number of longitudinal studies have now incorporated music into their assessment of whether overall media consumption by teenagers leads to earlier sexual activity. In one that dealt exclusively with music—a national telephone survey of nearly 1,500 teenagers, ages 12 to 17, with a one- to three-year follow-up—teens who listened to music with sexually degrading lyrics were more likely to begin having sexual intercourse early or advance in their noncoital sexual activities than teens who listened to other music (Martino et al., 2006). This was true even after controlling for 18 other determinants of early intercourse. Degrading sexual lyrics are more likely to focus on casual sex, “boys being boys,” and women’s primary usefulness as objects for sexual pleasure (Martino et al., 2006). This study’s findings are consistent with the theory that teens learn important cues about


sexual behavior (“scripts”) from media (Strasburger, 2012a; Ward & Friedman, 2006).

Music Videos. As Tennyson once wrote, “things seen are mightier than things heard.” Although music lyrics may be ambiguous or difficult even to hear or understand, there is no mistaking a scene of graphic violence, drug use, or a couple cavorting in bed together (Ashby & Rich, 2005). When a particular song is heard, listeners tend to flash back to the associated music video (Greenfield & Beagles-Roos, 1988). Therefore, music videos would seem to have a greater potential to affect attitudes and behavior than music alone, just as television is behaviorally more potent than radio.

Music Television (MTV) turned 30 in 2011. In the beginning, MTV aired performance videos (the band playing), concept videos (telling a story), and advertising. Although the performance videos could often be outlandish (e.g., David Lee Roth’s attire or his masturbating on stage with a huge inflatable phallus in the video “Yankee Rose”), there is no evidence that such videos had a demonstrable behavioral impact (Council on Communications and Media, 2009). They were roughly the equivalent of Elvis Presley gyrating his hips back in the 1950s. But concept videos do have effects: Numerous studies have shown that music videos frequently contain abundant sexual content (Ashby & Rich, 2005; Turner, 2011), and some have documented the effect of rap videos, particularly on male attitudes—objectification of women and turning them into sex objects, increased attitudes of sexual permissiveness, and even increased acceptance of date rape (Conrad, Dixon, & Zhang, 2009; Kaestle, Halpern, & Brown, 2007; Kistler & Lee, 2010; Ward, Hansbrough, & Walker, 2005; Zhang, Miller, & Harrison, 2008). In the only longitudinal study to date, 522 Black female adolescents with a median exposure to rap videos of 14 hours per week had engaged in a variety of risky sexual behaviors one year later, independent of other known factors (Wingood et al., 2003).

But as discussed above, MTV has morphed into more of a mainstream TV channel, having pioneered reality programs like The Real World and MTV’s Fear (Martin, 2010). Currently, Jersey Shore is a major reality hit, and MTV also airs Teen Mom 2, True Life, and Is She Really Going Out With Him?. TRL (Total Request Live) last aired in 2008. MTV began in 1981 as a network devoted to airing music videos 24 hours a day, but music videos are now confined to 3 to 9 a.m., weekdays only (VH1 devotes only slightly more time to videos). That does not mean that music videos as a medium are dead, however. Lady Gaga and YouTube have resurrected the form. In 2010,


“Bad Romance” had been viewed more than 244 million times, with Justin Bieber’s “Baby” lagging just behind and Miley Cyrus’s “Party in the U.S.A.” having received 138 million views (Setoodeh, 2010). (As of this writing, “Bad Romance” has been viewed almost 500 million times.) Every time YouTube broadcasts a video, it is accompanied by a brief ad. For every 1,000 ads seen, YouTube’s partner, Vevo, earns at least $25 (Setoodeh, 2010). Music videos are now being shared via Facebook, cell phones, and tweets.

New Technology Many people feel that new technology (the Internet, social networking

sites, cell phones and iPads, and Twitter) have revolutionized the way media are used. While new technology offers an interactivity not found in traditional media, it is also true that it has merely changed the platform that TV, movies, and videos are viewed on. For example, a 2009 Kaiser survey of two thousand 8- to 18-year-olds found that they spent an average of seven hours a day with a variety of different media, but TV remained predominant (Powers & Comstock, 2012; Rideout et al., 2010). TV viewing is actually at an all-time high, with Nielsen reporting that time spent watching TV and videos online rose 45% from 2010 to 2011 (Nielsen Company, 2011a). Although teenagers watch slightly less TV than children ages 2 to 11, total TV time still amounts to more than three hours per day (22:24 hours per week vs. 24:52 hours per week) (Nielsen Company, 2012).

New technology has allowed greater access to media 24/7, anytime, anywhere, as well as introduced new potential problems into the mix (e.g., displays of risky behavior on social networking sites, sexting, and Internet pornography) (Moreno & Whitehill, 2012). Although there is very little research other than content analyses, it is entirely possible that new media may be even more “potent” than traditional media when it comes to sex and sexuality (Collins, Martino, & Shaw, 2011). The Internet may be particularly appealing as a source of sex information for teenagers because it is readily available, anonymous, quick, and nonjudgmental. However, it is not always accurate: A review of 177 sexual health websites found below- average quality, with those sites that had the most complex or controversial topics containing the most inaccuracies (Buhi et al., 2010). An experiment with 210 first-year college students found that even heavy Internet users had difficulty finding accurate information about birth control (Mann, 2012).

Nevertheless, in the 2011 TECHsex USA survey of fifteen hundred 13- to


24-year-olds, the Internet was the leading source of information about a variety of sexual topics; and the media clearly outdistanced medical personnel, parents, and schools (Boyar, Levine, & Zensius, 2011) (see Figure 5.13). The bottom line here seems to be that the media—and particularly the Internet—may be replacing traditional sex education classes and parents as the primary source of sex education for young people. Another 2011 survey of two hundred 14- to 17-year-olds in Canada revealed that 40% rated the Internet more useful than parents for information about sex, and nearly one-quarter ranked it ahead of their high school sex ed classes (Tobin, 2011).

Figure 5.13 Avenues for learning about sex.

SOURCE: Boyar, Levine, and Zensius (2011).


Social Networking A study of MySpace profiles found that nearly one-quarter of them

referenced sexual behaviors (Moreno, Parks, Zimmerman, Brito, & Christakis, 2009). Adolescents who display explicit sexual references are also more likely to have online friends who do the same (Moreno, Brockman, Rogers, & Christakis, 2010). A smaller study examined 100 profiles posted by 16- to 18-year-olds and found that nearly half contained explicit or graphic language, and 16% contained references to sexual activity (A. L. Williams & Merten, 2008). A study of 752 publicly viewable profiles of teens 14 to 18 years old on a teen dating website found that 16% contained sexual content (Pujazon-Zazik, Manasse, & Orrell-Valente, 2012). Clearly, females who display sexual references on their social networking profiles may be influencing potential partners’ sexual expectations and dating intentions (Moreno, Swanson, Royer, & Roberts, 2011). To date, only three studies have examined the impact of sexual displays on social networking sites on actual behavior: A pilot study of 85 undergraduate freshmen found that displays of sexual references in Facebook profiles were positively associated with intention to begin having sexual intercourse (Moreno, Brockman, Wasserheit, & Christakis, 2012). And a National Study of Youth and Religion survey of 560 young adults, 18 to 23 years old, found that one-third of their MySpace profiles contained at least one sexual disclosure, and such disclosures were associated with risky sexual behaviors offline, like sex with casual partners (Bobkowski, Brown, & Neffa, 2012). Similarly, a recent study of 1,762 Dutch adolescents over two years found that online sexual risk behavior correlates significantly with offline sexual risk behavior (Baumgartner, Sumter, Peter, & Valkenburg, 2012).

Sexting Sexting has become an increasingly important issue, both for parents and

teens and for schools and law enforcement (Draper, 2012; Moreno & Kolb, 2012; Strasburger et al., 2012). It is a phenomenon that did not even exist 10 years ago but can have a devastating effect on individuals, as evidenced by the rare but heartbreaking and very well publicized examples of teens committing suicide as a result of sexting. There is an even newer and related phenomenon, termed sextortion, where an individual is blackmailed with the threat of being “sexted” because of the existence of explicit pictures of him or her (Wilson, 2010). But recent research finds that sexting may not be as common as previously thought. Initially, a national survey of nearly 1,300


teenagers in 2008 put the figure at 20%—a figure that triggered major alarm and national headlines (National Campaign to Prevent Teen and Unwanted Pregnancy, 2008). As might be expected, rates are even higher among young adults, with 43% reporting having sent or received a sext in a recent survey of nearly 3,500 individuals 18 to 24 years olds (Gordon-Messer, Bauermeister, Grodzinski, & Zimmerman, 2012). Two recent regional surveys have again found alarmingly high rates among teens. In a single private high school in the Southwest, researchers found that 17% of females and 18% of males had sent a sexually explicit picture via cell phone, and a remarkable 31% of females and 50% of males had received one (Strassberg, McKinnon, Sustaita, & Rullo, 2012). And a survey of 948 Texas public high school students found that 28% reported having sexted someone, 31% had asked someone for a sext, and more than half (57%) had been asked to sext. This was the first study to ask about sexual behavior in relation to sexting, however, and adolescents who had engaged in sexting behavior were far more likely to have begun having sex and to have engaged in risky sexual behaviors (Temple et al., 2012). A second study has also found that teenagers who sext are more likely to report being sexually active (Rice et al., 2012).

However, a very recent national study of 1,560 Internet users, ages 10 to 17, puts the sexting figure at a more conservative 1% for youth reporting having sent sexual images of themselves and 5.9% for youth reporting having received sexual images (Mitchell, Finkelhor, Jones, & Wolak, 2012) (see Table 5.5). Clearly, results of studies will vary according to the time frame assessed (within the past year? ever?), the age of the subjects (older teenagers are more likely to be involved in any sexually related behavior), and definition (is it “sexting” if you receive a sexual image or just if you send one?) (Lounsbury, Mitchell, & Finkelhor, 2011).

Table 5.5 How Prevalent Is Sexting?



Pornography Estimates are that the pornography industry generates between $10 and

$15 billion a year in the United States alone, more than Hollywood films ($10 billion a year) (Jensen, 2007). More than 13,000 adult videos are produced annually in the U.S. (Bridges, Wosnitzer, Scharrer, Sun, & Liberman, 2010). This is not your father’s pornography, however. What is now available, whether online, on DVDs, or on premium cable channels, can be raw, explicit, and involve virtually any combination and permutation you can think of. Playboy magazine—which in one older study 92% of teenage males had seen or read (D. Brown & Bryant, 1989)—now looks as innocent as Reader’s Digest by comparison. So one must view the research with a degree of caution: “Old” pornography research may not accurately


reflect the impact of “new” pornography.

Pornography is easily available online, but trying to assess whether teenagers are accessing it voluntarily or accidentally is definitely problematic. Even in confidential surveys, are teenagers really going to admit to unknown researchers that they have been searching for porn? A 2001 Kaiser survey found that nearly 70% of teens had been “accidentally” exposed to pornography online (Rideout, 2001). In the second Youth Internet Safety Survey (YISS-2) from 2005, 42% of the national sample of 1,500 youth 10 to 17 years old reported exposure, with two-thirds saying it was “unwanted” (Wolak, Mitchell, & Finkelhor, 2007). The YISS-3 survey in 2010 found that the “unwanted” figure had decreased to 23% (Jones, Mitchell, & Finkelhor, 2012). Another large study found that 93% of males and 62% of females reported having viewed pornography online by age 18 (Sabina, Wolak, & Finkelhor, 2008). A 2006 Australian study found that 92% of boys and 61% of girls, ages 13 to 16, had been exposed to online pornography (Ryan, 2012). And in a 2007 Canadian study of 429 students in 17 urban and rural schools in Alberta, Canada, 74% reported having viewed pornography online. In addition, more than one-third of the male teenagers reported having viewed pornographic DVDs or videos “too many times to count” (“One in Three Boys,” 2007). Pornography is viewed by teenagers worldwide and in similar numbers in Swedish, Italian, Taiwanese, and Australian studies (Flood, 2009). A very large Swiss study of more than 7,500 young people 16 to 20 years old found wanted exposure rates of 29% for males and, surprisingly, higher exposure rates for females at 36% (Luder et al., 2011). But, unfortunately, these rates were based on a 2002 survey and may not be accurate a decade later.

Most studies wanting to assess the impact of pornography on teenagers ask college students to recall their exposure. In a huge study of 16,799 college males and 11,338 college females, 82% of the males and 52% of the females said that they had been exposed to pornography by age 14 (Leahy, 2009). And pornography is becoming mainstream among young adults. For example, a study of 813 college students found that two-thirds of the males and half of the females thought that viewing pornography was acceptable (J. S. Carroll et al., 2008).

Is pornography now becoming more acceptable among teens as well? With rare exceptions, it is difficult to do such research (Strasburger, 2009). What has been done is based entirely on self-reports, and it is usually impossible to ask probing questions such as, “Exactly what sort of


pornography have you seen online?” and “Do you enjoy what you’ve seen?” Similarly, most researchers shy away from asking about the extent of exposure, just as they rarely ask about the extent of sexual activity in general, so a full picture of adolescent pornography is unusual. Europeans have a more benign attitude toward sex in general and adolescent sex and sexuality specifically, and so the most comprehensive study of teen pornography use was conducted in Sweden, examining 2,015 eighteen-year- old males and asking the above questions and many more (Svedin, Akerman, & Priebe, 2011). Ten percent of the subjects viewed pornography daily, 30% of the frequent viewers watched violent pornography, and nearly half of the frequent users were preoccupied with sex.

Considerable research has been done in the past 30 years, almost exclusively with adults. Older research suggests that sexualized violence against women, as seen in R-rated videos that are less sexually explicit but often far more violent than X-rated ones, probably do have antisocial effects. These contains scenes of women being tortured, murdered, or mutilated in a sexual context and may be the most important category for teenagers because they are more “mainstream” and represent an important genre of Hollywood films—the “slice ’em and dice ’em” movies (e.g., Halloween I–V, Friday the 13th I–VIII). Such films are frequently available on cable TV, and often the title alone tells the tale: Slaughter High, Splatter University, I Dismember Mama, Lunch Meat, Watch Me When I Kill, Chopping Mall, Deadtime Stories. A content analysis of popular porn videos found that 88% contained physical aggression (spanking, gagging, slapping), nearly half contained verbal aggression, and the perpetrators were almost always male, while the female targets often showed pleasure (Bridges et al., 2010).

Still, considerable controversy currently exists, and the newfound availability of pornography and the lack of new research have complicated the picture. But the latest research seems to suggest the following findings (Wright et al., 2012):

• Pornography is not necessarily “bad” for adults (Moyer, 2011). Many people report that they use pornography as a way of enhancing their sex lives (Hald & Malamuth, 2008).

• In general, pornography that is simply “erotica” (e.g., R- or X-rated material with implied or actual sexual contact but with no violence or coercion) probably has no or little antisocial effect on adults (Donnerstein, Linz, & Penrod, 1987; Malamuth & Huppin, 2005).


• However, the most recent meta-analysis of nine studies with more than 2,300 subjects did find that nonviolent pornography may affect a small number of predisposed individuals and tends to perpetuate the notion that women are sexually promiscuous and want to be dominated (Hald, Malamuth, & Yuen, 2010).

• Even for the very small number of men at risk for sexual aggression, the research suggests that large amounts of pornography—particularly violent pornography—must be consumed before behavioral effects become apparent (Wright et al., 2012). This may be true of juvenile sexual offenders as well (Alexy, Burgess, & Prentky, 2009).

Despite research constraints, several recent studies have examined the impact of pornography on teenagers’ sexual attitudes and even their sexual behavior. Remember that teenagers’ sexual attitudes and behaviors are a work in progress. All of these studies have found significant effects, particularly more callous sexual attitudes toward women (J. D. Brown & L’Engle, 2009; Peter & Valkenburg, 2006, 2008, 2009, 2011; Ybarra, Mitchell, et al., 2011). A study of 433 adolescents in New York City found that visiting sexually explicit websites was linked to a greater likelihood of having multiple lifetime sexual partners and having greater sexual permissiveness; but of course, this might be expected, given that it was a cross-sectional study (Braun-Courville & Rojas, 2009). A Swedish study also found a correlation between viewing pornography frequently and coercive sex, as well as risk taking behaviors like smoking, drinking, drug use, and even criminal behavior and buying sex; but it, too, was cross- sectional (Svedin et al., 2011).

Several longitudinal studies have included an assessment of X-rated media in their studies of teenagers’ media diets and have found behavioral effects. One study found an increase in “sexual preoccupation” with exposure to Internet pornography (J. D. Brown & L’Engle, 2009). A second recent longitudinal study of more than fifteen hundred 10- to 15-year-olds found a nearly sixfold increase in the odds of self-reported sexually aggressive behavior with exposure to violent X-rated material over time, whereas exposure to nonviolent X-rated material and sexually aggressive behavior were not statistically related (Ybarra et al., 2011). And a third longitudinal study found that exposure to X-rated material, including magazines, movies, and Internet porn, increased the risk of early sexual intercourse or oral sex (Delgado et al., 2009).


What the Research Says Unlike the violence research, studies of the impact of sexy media are, by necessity, considerably scarcer and more limited. Researchers cannot simply show a group of 13-year-olds several X-rated movies and then measure the attitudinal or behavioral changes that result. But a number of research modalities have yielded important data, and an increasing number of longitudinal studies have yielded data that potentially show cause and effect.

As previously discussed, content analyses simply assay the amount of sexual material in current programming, lyrics, movies, articles, or websites without addressing its effects. But analyses of every medium available show a strong trend toward increased sexual content, both suggestive and explicit. Simple common sense would tell us that this is not healthy for children and younger adolescents. But people want stronger evidence. Does all of this sexy content actually harm children, or is it merely fantasy and entertainment? Do teenagers who become sexually active at a younger age do so because of exposure to sexy media, or do they simply prefer to watch such programming?

Correlational Studies Correlational studies can help to address some of these issues, but they

do not and can not provide cause-and-effect answers. They are “static” studies: At one point in time, does a certain population exposed to more sexual content behave differently? If so, it could be that those who are more involved sexually simply choose to watch more sexual content in their media. This is the “chicken-and-egg” dilemma that has plagued correlational research for centuries, but such research is far easier to do than longitudinal studies and can provide important information if interpreted cautiously.

There is a long history of correlational research on this topic, dating back into the 1970s. Only studies done since 2000 will be discussed here, but older studies and newer studies are in agreement (a good, brief summary of older studies can be found in Wright et al., 2012):

• Teenagers who watch or read more sexual content are more likely than lighter viewers to have stereotypical ideas about sex. For


example, TV viewing is positively correlated with the belief that females are sex objects (Ward, Gorbine, & Cytron, 2002), that sex should occur early in a relationship (Aubrey, Harrison, Kramer, & Yellin, 2003), that casual sex is acceptable (Chia, 2006), and that most teenagers are already sexually active (Ward et al., 2002). Reality TV dating shows (Zurbriggen & Morgan, 2006) and TV talk shows (Ward & Friedman, 2006) have similar effects. Heavier viewers of TV are generally less satisfied with their own sex lives and have higher expectations of their prospective partners (Chia, 2006; Martino et al., 2005).

• Exposure to women’s magazines has been associated with stereotypical sexual beliefs, recreational attitudes toward sex, and a belief that birth control is unnecessary (Bleakley, Hennessy, Fishbein, & Jordan, 2009; Kim et al., 2007). Exposure to men’s magazines has been associated with permissive sexual attitudes and objectification of women (Taylor, 2006; Ward, Merriwether, & Caruthers, 2006).

• Heavy viewers of music videos are more likely to demonstrate stereotypical sexual beliefs, permissive sexual attitudes, less use of birth control, and (for males) greater acceptance of date rape (Kaestle et al., 2007; Ward et al., 2005; Zhang et al., 2008).

• Getting sex information from movies is positively correlated with the belief that birth control is not needed when having sex (Bleakley et al., 2009) and that overweight women are not sexually appealing (Hatoum & Belle, 2004).

• One recent study from Canada—a cross-sectional sample of 8,215 youth in Grades 6 to 10 and a one-year longitudinal sample of 1,424 youth in Grades 9 to 10—examined TV, computer, and video game use and a variety of risky behaviors (smoking, drunkenness, marijuana use, other illicit drug use, nonuse of seatbelts, and nonuse of condoms). High computer use was the screen-time behavior most strongly and consistently associated with risky behaviors, including nonuse of condoms. Youth in the highest quartile were 53% more likely to engage in risky behaviors. For TV use, the risk was 30% higher (Carson, Pickett, & Janssen, 2011).

• Many cross-sectional studies have found an association between exposure to a variety of media and increased likelihood of earlier sexual intercourse (Fisher et al., 2009; Pardun, L’Engle, & Brown, 2005; Pazos et al., 2001; Ward & Friedman, 2006), oral sex (Fisher et al., 2009), failure to use condoms (Carson et al., 2011), and


intention to begin having sex (Chia, 2006; L’Engle, Brown, & Kenneavy, 2006; Pardun et al., 2005). This is true of international studies as well; a study of more than seventeen thousand 15- to 24- year-olds in Asia found that exposure to sexual content is associated with earlier sexual activity (Cheng, Lou, Gao, & Zabin, 2013, in press). One American study found that African American female teens who had had greater exposure to rap music videos or X-rated movies were more likely to have had multiple sexual partners and test positive for a sexually transmitted disease (Wingood et al., 2001).

Overall, media exposure—particularly exposure to a lot of sexual content —clearly has an impact on teenagers’ beliefs and attitudes about sex.

Experimental Studies Several experimental studies have been done since 2000, mostly with

young adults. Only two have specifically studied adolescents, and they have concluded that exposure to music videos (Ward et al., 2005) and to TV sitcoms and dramas (Ward & Friedman, 2006) enhances sexual stereotypes and objectification of women. At least nine studies have been conducted using young adults, and the findings have been very similar to those from the correlational studies discussed above (Emmers-Sommer, Pauley, Hanzal, & Triplett, 2006; Eyal & Kunkel, 2008; Farrar, 2006; Ferguson, Berlin, & Noles, 2005; Mazur & Emmers-Sommer, 2002; Nabi & Clark, 2008; Taylor, 2005a, 2005b). Experimental studies have frequently been criticized because of their “artificiality,” but in this case, the fact that the findings are congruent with correlational and longitudinal studies means that they should not be summarily dismissed.

Longitudinal Studies Up until the last decade, there were no substantial longitudinal studies

that could implicate or absolve sexy media content in terms of leading to early teen sex. But that situation has recently changed. As stated at the beginning of the chapter, there are 18 studies that use longitudinal data (although, again, some of these studies reuse the same population sample to draw their conclusions) (see Table 5.6). In addition, a 19th study has found an association between viewing sexual content on TV and regret over having sex too early among males but not among females (Martino, Collins, Elliott, Kanouse, & Berry, 2009).


In the first study of its kind, California researchers found that teens exposed to sexy media were more likely to begin having intercourse at a younger age. Nearly 1,800 teens, ages 12 to 17, were studied initially and then a year later. Exposure to sexy media doubled the risk of their initiating sexual intercourse or advancing significantly in their noncoital sexual activity (Collins et al., 2004). Similar findings were reported using data from the National Longitudinal Study of Adolescent Health. In a study of nearly 5,000 teenagers younger than 16 who had not yet had sexual intercourse, researchers found that those who watched more than two hours of TV per day were nearly twice as likely to begin having sex within a year, compared with lighter viewers (Ashby et al., 2006). Finally, the “gold standard” study was done by J. D. Brown and her colleagues (2006) using a sexual media diet comprising not only TV but movies, music, and print media as well. Exposure to a heavier sexual media diet among one thousand 12- to 14-year-olds in North Carolina accelerated White adolescents’ sexual activity and doubled their risk of early intercourse within two years (see Figure 5.14). The study was compelling and comprehensive in every way, except for omitting exposure to online pornography.

Table 5.6 Recent Studies of the Impact of Sexual Content on Sexual Behavior Using Longitudinal Data




Since the North Carolina study, the findings have been replicated and expanded to include a variety of different media, including the Internet. Only one of the 17 studies has failed to find an overall impact of sexual content on sexual behavior, but it did find that exposure to TV sitcoms was more


likely to predict a history of sexual intercourse a year later compared with exposure to dramas (Gottfried et al., 2011). Several interesting findings have emerged from these longitudinal studies:

Figure 5.14 Sexual media diet (SMD) and risk of early sexual intercourse.

SOURCE: J. D. Brown, L’Engle, and colleagues (2006).

NOTE: New research has found a doubled risk of early sexual intercourse with exposure to more sexual content in a variety of different media.

• As in other areas of media research (e.g., the relationship between advertisements and cigarette smoking), African Americans seem more resistant to being influenced by media than Whites do, perhaps because they do not see themselves portrayed in the media very often (Hennessy et al., 2009).

• Most of the studies involved sample sizes of 500 to 1,000 teenagers, but a few were quite large (e.g., Ashby et al., 2006; Collins et al., 2004). Similarly, most were relatively short term, one to two years, but one involved a five-year survey and examined children as young


as 7 years old (Delgado et al., 2009). • Several studies specifically included Internet pornography (J. D.

Brown & L’Engle, 2009; L’Engle & Jackson, 2008; Peter & Valkenburg, 2008; Ybarra, Mitchell, et al., 2011).

• Several studies included music, including the most intriguing study, which studied more than twelve hundred 12- to 17-year-olds over a three-year period and found that listening to songs with degrading sexual lyrics predicted earlier intercourse (Martino et al., 2006).

• One three-year study actually found that exposure to sexual content on TV was a significant predictor of teen pregnancy (Chandra et al., 2008).

• Perhaps the greatest behavioral effect was found in the study of nearly twelve hundred 10- to 15-year-olds’ exposure to X-rated media over a three-year period. The risk of sexually aggressive behavior increased nearly sixfold (Ybarra, Mitchell, et al., 2011).

How good is the research? Media research is difficult to do in general, but factor in the element of sex and it becomes extraordinarily difficult. Not only is funding generally unavailable, but schools and parents are reluctant to consent to any research dealing with children, adolescents, and sex and sexuality. Even with funding and access, institutional review boards at universities are reticent to approve such research. So the odds are stacked against media researchers, and consequently it is difficult to be overly critical of the 18 recent studies mentioned above. There are doubters (Steinberg & Monahan, 2011), but there always seem to be doubters of media research and media’s impact on young people. It is almost as if there is a corollary to the third-person effect whereby society as a whole does not want to believe that the media can actually affect behavior.

So to answer the question of how good the research is, we have to ask, how large is the effect? Many studies find that exposure to sexual media content predicts between 10% and 20% of the variance, similar to media violence studies. And from a social science perspective, the ability to predict this much of the variance is highly significant. Defining the impact of media, when it is all around us, is like trying to assess the effect of pollution on the air we breathe—it may be subtle, but it is important to measure and control (Comstock & Strasburger, 1993). Taken together, the correlational, experimental, and longitudinal studies all speak to the power of the media to educate children and teens about sex and sexuality and to influence their attitudes, beliefs, and behaviors in a significant way.


Why Teenagers May Be Particularly Susceptible to Sexual Content in the Media Teenagers sometimes seek to resemble actors and actresses as they experiment with different facets of their newly forming identities and try on different social “masks.” In particular, the combined idiosyncrasies of adolescent psychology seem to conspire against successful use of contraception during early and middle adolescence (Strasburger et al., 2006). Teenagers often see themselves egocentrically as actors in their own “personal fable” (Elkind, 1993), in which the normal rules (e.g., having unprotected sexual intercourse may lead to pregnancy) are suspended— exactly as on television and in the movies. Even though 70% of teenagers, by age 16, have reached the final level of cognitive operational thinking described by Piaget (1972)—sequential logical thinking (formal operations) —they may still suffer from what Elkind (1984) calls “pseudostupidity”: “The capacity to conceive many different alternatives is not immediately coupled with the ability to assign priorities and to decide which choice is more or less appropriate than others” (p. 384).

Although teenagers are probably not as susceptible as young children to media violence, they may be more susceptible to sexual content (Chia, 2006; Martino et al., 2005). Regular exposure to sexy media may alter teenagers’ self-perceptions as well. In one study, two-thirds of sexually experienced teenagers in a three-year study of more than two thousand 12- to 17-year-olds said that they wished they had waited longer to have intercourse for the first time, and exposure to sexual content was positively associated with the likelihood of regret among males (Martino et al., 2009). Teenage girls frequently say that they want to be “in love” before they have sex, yet Hollywood movies portray very confusing images of what being in love actually means (K. R. Johnson & Holmes, 2009; Pardun, 2002). In short, the media may act as a kind of “super-peer” in exerting pressure on teenagers to begin having sex and making sexual activity seem like normative behavior for teens—a theory originally proposed by Strasburger (1995) and later supported by data from J. D. Brown, Halpern, and L’Engle (2005). Teenagers frequently cite their friends as being a major source of information about sex (Bleakley et al., 2009), but where do their friends get their information?

Teenagers typically overestimate the number of their peers who are engaging in sexual intercourse (National Campaign to Prevent Teen


Pregnancy, 2004). Several studies document that teens who are avid consumers of media are more likely to overestimate the number of their peers and friends who are sexually active and to feel more pressure from the media to begin having sex than they feel from friends (Kaiser Family Foundation & Children Now, 1999; M. E. Tucker, 2000). In an anonymous survey of 1,015 Seventeen readers, ages 13 to 19, three-fourths believed that most teenagers were having sex, whereas only about half actually were (M. E. Tucker, 2000). Remarkably, in one survey of 2,100 preteen and teenage girls, only 11-year-olds said they did not feel pressure from the media to have sex (Haag, 1999). Early maturing girls are more likely to seek out sexual content in a variety of different media and to interpret that content as approving of teens having sex (J. D. Brown et al., 2005). This may represent a manifestation of the “cultivation hypothesis” as well—the notion that the more time viewers spend with media, the more their views of the world will be altered by what they see (Morgan, Shanahan, & Signorielli, 2009). Teenagers who are heavy users of media clearly get an eyeful and earful of sexual activity and therefore think that everyone is “doing it” except for them.

Interestingly, when teenagers are asked about the influence of media, they acknowledge media as an important source of information about sex but are equally quick to point out that the media have no influence on their own behavior. This is the well-known third-person effect— everyone is influenced by the media except oneself (Perloff, 2009). For teens, the very idea that something as simplistic and ordinary as the media could influence them is insulting; they are far more “sophisticated” than that. Yet they are willing to acknowledge peers as an influence, and who influences their peers (see Table 5.7). Similarly, when a Canadian survey asked nearly 1,200 teens ages 14 to 17 about their role models for healthy sexual behavior, 45% named their parents, 32% named their friends, and only 15% said that media celebrities influenced them (University of Montreal, 2011).

Table 5.7 Sources of Information About Sex for 14- to 16-Year-Olds (N = 458)


SOURCE: Adapted from Bleakley, Hennessy, Fishbein, and Jordan (2009).

Contraceptive Advertising It’s so hypocritical for any network in this culture to go all puritanical on the subject of condom use when their programming is so salacious. I mean, let’s get real here. Fox and CBS and all of them are in the business of nonstop soft porn, but God forbid we should use a condom . . .

—Media critic Mark Crispin Miller as quoted in The New York Times (Newman, 2007)

Failure to use contraception is an international problem. A recent survey of more than 6,000 young people in 29 countries, including Chile, Poland, and China, found that unsafe sex with a new partner had increased by 111% in France, 39% in the U.S., and 19% in Britain in the past three years (Bayer HealthCare Pharmaceuticals, 2011).

But the U.S. has the highest teenage pregnancy rate of 37 developed countries despite the fact that American teenagers are no more sexually active than French or Canadian or Belgian teens. There are only two possible hypotheses to explain why: Either American female teens are extremely fertile, or American teens do not use birth control as effectively as teens in other countries. In fact, these data confirm that American society limits access to birth control for teenagers in three vital ways—via their physicians (who are reluctant to prescribe it), their media (which are reluctant to mention it), and their school-based sex education programs


(which are reluctant to talk about it) (Strasburger, 2012a, 2012b).

It seems odd, perhaps even hypocritical, that as American culture has become increasingly “sexualized” in the past 30 years, the one taboo remaining is the public mention of birth control. In 1985, the American College of Obstetricians and Gynecologists (ACOG) made headlines when its public service announcement about teen pregnancy, titled “I Intend,” was banned from all three major networks. The one offensive line that had to be removed before the networks agreed to run the PSA said, “Unintended pregnancies have risks . . . greater risks than any of today’s contraceptives” (Strasburger, 1989, p. 767). By 2006, contraceptive advertisements occasionally appeared in national network programming but were mostly for the “patch” or Ortho Tri-Cyclen and mentioned only ease of use or improvement in acne, not pregnancy prevention (see Figure 5.14) (Strasburger, 2012a; Strasburger & Council on Communications and Media, 2010). A year later, in another well-publicized incident, both FOX and CBS refused to air an ad for Trojan condoms (“Evolve. Use a condom every time.”) because the two networks would air only condom ads that restricted their content to talking about preventing HIV and AIDS, not other sexually transmitted infections (STIs) or pregnancy (Brodesser-akner, 2007). Two of the six major networks refuse to air condom ads at all, and three others will air them only after 9 p.m. or 11 p.m. Several networks also refuse to air ads for birth control pills, and the ones that do permit them refuse to allow use of the words “prevent pregnancy” (Espey, Cosgrove, & Ogburn, 2007). Ads for emergency contraception are virtually nonexistent, yet every year American women have 3 million unplanned pregnancies, and less than half of teen mothers ages 15 to 19 years with unintended pregnancies report having used contraception (Centers for Disease Control and Prevention, 2012a) (see Figure 5.15). Advertising emergency contraception could be a major way to reduce the 1.3 million abortions that occur in the U.S. every year (Kristof, 2006). Yet network executives claim, without given any evidence for their assertions, that PSAs or advertisements for birth control products would offend many viewers.

The situation remains virtually the same as it did in 1985. However, birth control ads do air on many local TV stations around the United States (e.g., KABC-TV, Los Angeles) and on cable networks like Lifetime without complaints being registered. In addition, several national surveys of adults have found that a majority of Americans —including 62% of the Catholics surveyed—favor birth control advertising on television (Harris & Associates, 1987; Kaiser Family Foundation, 2001). In fact, more adults


oppose beer ads (34%) than condom ads (25%) (Kaiser Family Foundation, 2001). By contrast, in the UK, a recent government decision allows condom ads—previously banned before 9 p.m.—to be aired at any time, provided that they are not shown during programs popular with children under age 10 and are tastefully done. The government advisory group that made the recommendation cited the fact that the UK has the highest teen pregnancy rate in Europe and rising rates of STIs (Hickman, 2010).

Meanwhile, two dramatic changes have occurred. In 2009, the Food and Drug Administration required Bayer HealthCare Pharmaceuticals to run a new $20 million advertising campaign for Yaz, the most popular birth control pill in the U.S., to correct the misperception from previous ads that women should take Yaz to cure their acne or their premenstrual syndrome symptoms (Singer, 2009). Unfortunately, the second change is not as proactive: Ads for Viagra, Cialis, and Levitra have now become ubiquitous and make sex seem like a recreational sport (see Figure 5.16). In 2006, $241 million was spent advertising erectile dysfunction (ED) drugs, which helped boost sales to $1.4 billion (Agovino, 2007). The apparent “disconnect” between the networks’ willingness to air ads for ED drugs and their unwillingness to air ads for birth control products seems hypocritical at best (Strasburger & Council on Communications and Media, 2010). As one researcher notes,

Figure 5.15 Percentage of teen mothers aged 15-19 years with unintended pregnancies resulting in live births who reported no contraceptive use before pregnancy —19 states* participating in Pregnancy Risk Assesment Monitoring System (PRAMS). 2004–2008


SOURCE: Centers for Disease Control and Prevention (2012a).

*Alaska, Arkansas, Colorado, Geogia, Hawaii, Illinois, Maryland, Maine, Michigan, Minnesota, Nebraska, New Jersey, New York, Oklahama, Oregon, Rhode Island, Utah, Washington, and West Virginia.

† 95% confidence interval.

National sex surveys show that whether we’re married or single, we’re not having sex all the time. But these ads make us think we should be. The whole point of most ads is to make us feel inadequate. Without that as a motivation why would we buy something? (L. Carroll, 2010)

The only positive note is that in 2011, GlaxoSmithKline—the makers of Levitra—decided to suspend their advertising. GSK’s president explained that while Glaxo believes erectile dysfunction is a legitimate medical condition, it “certainly is not a condition parents, aunts, uncles and grandparents want to explain to children while watching a football game on Thanksgiving” (Loftus, 2011).

Would advertising of condoms and birth control pills have an impact on the rates of teen pregnancy or acquisition of HIV? Considerable data seem to indicate that the answer is yes: European countries have far lower rates of teen pregnancy and far more widespread media discussion and advertising of birth control products (Advocates for Youth, 2011). Furthermore, according to Population Services International, when Zaire


began advertising condoms, there was a 20-fold increase in the number of condoms sold in just three years—from 900,000 in 1988 to 18 million in 1991 (Alter, 1994). More recently, a study of condom advertising in Pakistan showed significant increases in discussion of family planning and use of condoms (Agha & Meekers, 2010). In a relevant “natural experiment,” Earvin “Magic” Johnson’s announcement of his HIV infection was associated with a decline in one-night stands and sex with multiple partners in the subsequent 14 weeks, according to a Maryland study (CDC, 1993). It also resulted in increased awareness about AIDS (Kalichman & Hunter, 1992).

Figure 5.16

SOURCE: Steve Kelley Editorial Cartoon ©2006 Steve Kelley. All rights reserved. Used with the permission of Steve Kelley and Creators Syndicate.

On the other hand, would advertising birth control products make teenagers more sexually active than they already are? There is no evidence available indicating that allowing freer access to birth control encourages teenagers to become sexually active at a younger age (Farrar, 2006; Mueller, Gavin, & Kulkarni, 2008; Reichelt, 1978; Strasburger et al., 2006). In fact, the data indicate the exact opposite: There are now at least nine peer-reviewed, controlled clinical trials showing that giving teens freer


access to condoms does not increase their sexual activity or push virginal teenagers into having sex, but does increase the use of condoms among those who are sexually active (Blake et al., 2003; Furstenberg, Geitz, Teitler, & Weiss, 1997; Guttmacher et al., 1997; Jemmott, Jemmott, & Fong, 1998; Kirby et al., 1999; Schuster, Bell, Berry, & Kanouse, 1998; Sellers, McGraw, & McKinlay, 1994; Wolk & Rosenbaum, 1995; Wretzel, Visintainer, & Koenigs, 2011). Typically, teenage females engage in unprotected intercourse for six months to a year before seeking medical attention for birth control (Strasburger et al., 2006). Organizations such as the American Academy of Pediatrics, ACOG, and the Society for Adolescent Medicine have all called for contraceptive advertising on American television (Espey et al., 2007; Society for Adolescent Medicine, 2000; Strasburger & Council on Communications and Media, 2010). Despite the hopes of many public health officials, the fear of AIDS may not be sufficient to increase teenagers’ use of contraception. Thus, a major potential solution to a significant American health problem is being thwarted by the networks and the many people who misunderstand the “science” of teen pregnancy.

Prosocial Sexual Content on Television One of the most appealing and practical approaches to address public health concerns about television has been dubbed “edutainment”—the practice of embedding socially responsible messages into mainstream programming (Brown & Strasburger, 2007; Kaiser Family Foundation, 2004). Although this occurs infrequently, the impact can be significant and speaks to the ability of some writers and producers to be extremely socially conscious:

• During the 1999 TV season, the Media Project (a partnership between Advocates for Youth and the Kaiser Family Foundation) worked with the producers of Felicity on a two-part episode about date rape. The Project encouraged the creation of a toll-free rape crisis hotline number to be displayed at the end of the episode, and the hotline received more than 1,000 calls directly after the show aired (Folb, 2000). In a small survey about a later episode that discussed birth control, more than one-fourth of 12- to 21-year-olds surveyed felt they had learned something new about birth control and safe sex.

• In 2002, Friends aired an episode about condoms, and 27% of a


national sample of teens saw the program. Nearly half the teens watched the episode with an adult, and 10% talked about condom efficiency as a direct result of the episode (Collins, Elliott, Berry, Kanouse, & Hunter, 2003).

• Collaborative efforts between the Kaiser Family Foundation and the producers of the hit show ER resulted in successful storylines about the risks of human papillomavirus (HPV) and the usefulness of emergency contraception (Brodie et al., 2001) (see Figure 5.17).

• In England, one of the characters in the hit show Coronation Street died of cervical cancer, resulting in a 21% increase in Pap smears in the 19 weeks after the show aired (Howe et al., 2002).

• The Soap Opera Summit in Hollywood and international efforts to embed storylines in popular soap operas are other examples of prosocial efforts. For example, media giant Viacom and the Kaiser Family Foundation launched an ambitious project in 2003 to produce $120 million worth of public service announcements and print ads concerning HIV/AIDS and to encourage Viacom producers to include storylines in their TV shows that would raise AIDS awareness (Tannen, 2003).

• In 2008, a study showed that the viewers of a Gray’s Anatomy episode learned that HIV-positive mothers could still have HIV- negative babies (Rideout, 2008). The media have actually played a major role in educating the public about HIV (DeJong, Wolf, & Austin, 2001; Romer et al., 2009).

Although these instances can probably still be counted on the fingers of two hands, they do demonstrate that the entertainment industry can be remarkably receptive to outside input and that healthier content can be introduced into mainstream television without government pressure or the threat of censorship.

Figure 5.17 Viewers’ knowledge increased after storylines on the hit show ER featured emergency contraception and human papillomavirus (HPV).


SOURCE: Brodie and colleagues (2001). Reprinted with permission from the Kaiser Family Foundation.

The mass media have also been used proactively to try to increase parent-child communication about sex. In North Carolina, a mass media campaign used billboards (see Figure 5.18) and radio and TV PSAs with the theme “Talk to your kids about sex. Everyone else is.” The impact of the campaign was assessed via a post-exposure survey to 1,132 parents of adolescents living in the 32 counties covered by the campaign. Parents’ exposure to a billboard message or PSA significantly correlated with talking to their child about sex during the following month (DuRant, Wolfson, LaFrance, Balkrishnan, & Altman, 2006; Evans, Davis, Umanzor, Patel, & Khan, 2011).

Meanwhile, new technology has resulted in an explosion of new and creative ways of reaching teenagers with prosocial health messages (Boyar et al., 2011; Bull, Levine, Black, Schmiege, & Santelli, 2012; Collins, Martino, & Shaw, 2011). Since teenagers are texters, a number of organizations have created text messaging services for information about sex (Hoffman, 2011b). The San Francisco Department of Public Health has created “SexInfo,” whereby a five-digit number links users to a menu of options about sexual health and referral options. In its first 25 weeks, the service received 4,500 texts (Levine, McCright, Dobkin, Woodruff, & Klausner, 2008). A statewide version of the program, titled “HookUp,”


allows users to access clinics in their area by texting “CLINIC” and their zip code. After nine months, nearly 3,000 subscribers had enrolled and one- third had obtained clinic appointments (Braun, Howard, & Madsen, 2010). Results of STI tests have been texted in a unique program in Washington, DC. Nearly 8,000 teens in 33 schools were introduced to the program, with 66% to 75% providing urine specimens for STI testing and a 5% to 9% receiving a positive test result (Winston, 2010).

Figure 5.18 Billboards used in a North Carolina mass media campaign.

As previously discussed, the Internet may be becoming the single greatest source of sex information for teens (Boyar et al., 2011). Many responsible online websites exist (e.g., Planned Parenthood, Go Ask Alice, Healthy


Teen Network, Advocates for Youth, National Campaign to Prevent Teen and Unwanted Pregnancy). Some organizations have established very interactive websites for teens—for example, Boston Children’s Hospital (, American Social Health Association (, the California Family Health Council (, and the Atlantic Health System ( (Borzekowski, McCarthy, & Rosenfeld, 2012). To date, none of these sites have been evaluated for their behavioral impact, but two older studies have examined content (Keller, LaBelle, Karimi, & Gupta, 2002; Noar, Clark, Cole, & Lustria, 2006). Of 21 Internet sites providing sex information specifically for teens, most advised the need for safe sex (95%), the use of condoms (95%), and abstinence as a primary prevention strategy (67%), but the sites surveyed seldom dealt with more difficult issues like sexual orientation (Noar et al., 2006).

Social networking sites on the Internet also have the potential to be used for prosocial purposes (Ralph, Berglas, Schwartz, & Brindis, 2011) and to teach young people about media literacy on the Internet. In one small but unique study, researchers sent an email from “Dr. Meg” to users who made three or more references in their profiles to sexual behaviors or drug use. The email warned that there are risks to disclosing such personal information online and encouraged the user to revise the profile. At follow- up, 13.7% of the sexual references and 26% of the drug references had been removed (Moreno, VanderStoep, et al., 2009). On the other hand, a social marketing campaign designed to increased condom use in 12 western U.S. neighborhoods failed (Bull et al., 2008). But a newer randomized controlled trial with 1,578 older teens and young adults used Facebook to deliver STI- prevention messages and resulted in significant increases in condom use after six months (Bull et al., 2012).

Finally, a variety of video games and programs have been developed that can be played either on cell phones or Internet platforms. It’s Your Game: Keep It Real is a middle school sex ed program that includes computer components and was piloted in Texas with an urban, low-income 7th- to 8th-grade population. On follow-up of the students in 9th grade, one-third of the students in the control group had initiated sex compared with one-fourth of the students receiving the program (Tortolero et al., 2009). What Could You Do?, an interactive one-hour video that teaches about sexual decision making, was tested on 300 urban adolescent females in Pittsburgh. At six- month follow-up, more abstinence, better use of condoms, and less STIs


were reported in comparison with controls (Downs et al., 2004). In Project Light, an interesting variation on the use of video games, researchers compared a computer-based program with an in-person training and found the former to be more effective (Lightfoot, Comulada, & Stover, 2007). Many other creative uses for texting, social networking sites, and computer games are currently in development or have not yet been formally tested but potentially offer great promise for the future (Collins et al., 2011).

Solutions Clearly, there is a strong case to be made for the impact of sexual content in a variety of media on young, impressionable preteens and teens (J. D. Brown, 2008; Escobar-Chaves et al., 2005; Strasburger, 2012a; Strasburger & Council on Communications and Media, 2010; Wright et al., 2012). In a society that limits access to sexual information, teenagers look to the media for answers to their questions. More important, the media may have a strong effect on teens without their even being aware of it, especially those whose parents do not inculcate in them a strong sense of “family values.” Important questions get answered by the media: “When is it okay to have sex?” “How do I know if I’m in love?” “Is sex fun?” “Is sex risky?” Unfortunately, as we have seen, media answers to these questions are often not the healthiest or most accurate.

What changes in media would give American youth a healthier view of sex and sexuality? A number of possibilities come to mind:

1. Widespread advertising of birth control in mainstream media (e.g., TV, magazines, radio). Advertising birth control represents one means of increasing teenagers’ access to it. Such advertising needs to address the risks of pregnancy, not merely the cosmetic difference that birth control pills can make if a teenager has acne. Unless new products such as the morning-after pill are widely advertised, teenagers will not know about them or use them (see Figure 5.19). Comparative studies between the United States and Europe make it clear that countries that promote the use of birth control via advertising, sex education classes, and programming are rewarded with lower rates of teen pregnancy (Advocates for Youth 2011; Mueller et al., 2008; Strasburger et al., 2006). Most national surveys have documented that adults favor birth control advertising (Mozes,


2001), yet the media remain resistant. Given that nine studies now indicate that making birth control available to teenagers does not increase the risk of early sexual intercourse, there is no longer any excuse to withhold access to it.

2. Greater responsibility and accountability of mainstream media for producing healthy and accurate messages about sex and sexuality. Entertainment industry executives need to realize that, like it or not, their product is educating American children and teenagers. Media have become one of the most important sources for sexual information for young people today (see Table 5.8) (J. D. Brown, L’Engle, et al., 2006; Levine, 2011; Strasburger, 2012a). Yet what they view on television and in the movies is almost counterproductive to healthy adolescence: frequent premarital sex and sex between unmarried partners, talk about infidelity on talk shows, graphic jokes and innuendoes in the movies, rape myths, and sexual violence. Where is the depiction of sexual responsibility? Where is the talk about the need for birth control or the risk of STDs? Where are the depictions of condom use when they are most needed in modern society? Why aren’t topics such as abortion, date rape, and rape myths portrayed and examined in greater detail (Navarro, 2007)? When two-thirds of sexually experienced teenagers in the U.S. say they wish they had waited longer to have intercourse for the first time, a more accurate portrayal of human sexuality in mainstream media would seem to be indicated (Martino et al., 2009). Clearly, as evidenced by the changing portrayal of sexual minorities in prime-time TV programming, Hollywood can be proactive and responsible.

In the new millennium, however, the answer is not a return to the “golden age” of the 1950s, when sex was rarely discussed and Laura and Rob Petrie slept in separate beds on The Dick Van Dyke Show despite being married. Nor should censorship be tolerated in a free society. Voluntary restraint and good judgment on the part of Hollywood and television writers, producers, and directors, however, would go far in improving the current dismal state of programming (see Table 5.9).

Figure 5.19 Ads for emergency contraception.


SOURCE: The EC campaign is coordinated by the National Institute for Reproductive Health, the national research, education, and training arm of NARAL Pro-Choice New York. Mifeprex is a registered trademark of Danco Laboratories, LLC.

Table 5.8 Five Media Strategies for Sexual Health

SOURCE: Adapted from J. D. Brown (2008).

A return to the “family hours” of protected programming between 7 p.m. and 9 p.m. would be one useful idea. Boston Public, which aired at 7 p.m Central and Mountain time, featured such storylines as a high school girl trading oral sex for a boy’s agreement to withdraw from a student council race, a girl tossing her breast pads away in the hallway, and another high school girl’s sexual affair with one of the teachers. Unfortunately, as one TV critic notes, “Almost anything goes


in primetime . . . TV says get used to it” (Salamon, 2000, p. 6WK). Yet, in 2005, Boston Public’s writer-producer, David E. Kelley, handled the theme of emergency contraception being refused in a Catholic hospital emergency room extremely fairly and sensitively in a Boston Legal episode. Another positive development was the 2006 “Pause” public education campaign by FOX and the Kaiser Family Foundation that tried to teach teenagers to make wise decisions about difficult issues, including sex and teenage pregnancy (Kaiser Family Foundation, 2006). Clearly, Hollywood is capable of dealing with the theme of adolescent sexuality in a responsible way when it wants to, but such campaigns are often short-lived and their effectiveness has not been tested.

3. Better taste in advertising (see Exercises for a discussion of “taste”). When sex is used to sell products, it is cheapened and devalued. Manufacturers who pay for advertising and companies that produce it need to recognize that they, too, have a public health responsibility to produce ads that are not gratuitously provocative, suggestive, or demeaning (see Figure 5.20). Kilbourne’s Deadly Persuasion (1999) should be a must-read for all account executives.

Table 5.9 Guide to Responsible Sexual Content in Media

SOURCE: Strasburger (1995). Modified from Haffner and Kelly (1987, pp. 9–11).


Figure 5.20 Inappropriate use of sexuality in ads.

SOURCE: ©2008 Calvin Klein. All rights reserved.

4. Using new media creatively to provide young people with accurate information about sex and sexuality. Web-based outreach may help connect young people to the sexual health services they need (Ralph et al., 2011), and the Internet could prove invaluable as a source of reliable sex information, especially at a time when many schools are failing to provide comprehensive sex education (Guse et al., 2012; Martinez et al., 2010). A text messaging service that gives weekly messages relating to sexual health has been successfully piloted (Perry, Kayekjian, Braun, Sheoran, & Chung, 2012). The makers of Trojan condoms have partnered with to create online videos that answer more than 100 common questions about sex, STDs, and birth control (Fard, 2012). In Texas, which has the fifth highest teen pregnancy rate in the country and where 96% of the public schools still have abstinence-only sex ed curricula, a new initiative in Austin allows teens to text sex or reproductive health questions to experts and receive a response within 24 hours (Mulvaney, 2012). And MTV has actually pioneered an iPhone app that uses GPS to search for the nearest place that sells condoms (Sniderman, 2011). Using new technology may actually help clinicians prevent and treat STDs: In North Carolina, health department officials used social networking sites to locate 80% of at-


risk individuals during an outbreak of syphilis (Clark-Flory, 2012). 5. Incorporating the principles of media education into existing sex

education programs. Several studies seem to indicate that a media education approach may be effective in decreasing children’s aggressive attitudes and behaviors, promoting better nutritional habits and decreasing their risk of obesity, decreasing their susceptibility to advertising, and reducing their use of alcohol and tobacco (J. D. Brown, 2006; Council on Communications and Media, 2010; Pinkleton, Austin, Chen, & Cohen, 2012) (see Chapter 12). There is no reason to think that helping children and teenagers decipher sexual content, the suggestiveness of advertising, and the conservatism of the broadcast industry regarding contraception would have anything but positive outcomes. In fact, a recent media literacy curriculum conducted at 22 school sites in Washington state found that a five- lesson plan targeting 532 middle school students resulted in their being less likely to overestimate sexual activity among their peers and more aware of the truth about sex and sexual imagery in the media (Pinkleton, Austin, Cohen, Chen, & Fitzgerald, 2008). One group of Australian researchers is actually updating sex ed resources in that country to address the widespread availability of pornography and help teachers confront the issue (Ryan, 2012).

6. More and better counteradvertising. To date, only the National Campaign to Prevent Teen and Unwanted Pregnancy has engaged in long-term efforts to counterprogram through the national media (see Figure 5.21a). One organization has even taken on the abstinence movement (see Figure 5.21b). Although no data exist about their success, the communications literature about drugs and media does contain several successful efforts involving counteradvertising against tobacco and illicit drugs with teens as the primary target audience (see Chapter 6). On the other hand, scare tactics that exploit the fear of HIV/AIDS to try to prevent early teenage sexual activity are unethical and probably counterproductive (DeJong et al., 2001; Strasburger, 2012a).

Figure 5.21 Counteradvertising.


SOURCE: Grant Hill.

7. Greater sensitivity of parents, schools, and society in general to the influence of the media on children and adolescents. Many parents often seem to be “clueless” about the impact of media on their children and teenagers (Strasburger, 2006), although a 2007 survey of 1,008 parents nationwide found that two-thirds felt that they were “closely monitoring” their children’s media use (Rideout, 2007). The most important steps that parents can take are to set rules about TV viewing, monitor what shows are being watched, and keep TV sets out of the bedroom (Council on Communications and Media, 2010; Fisher et al., 2009). A national study of 1,762 teenagers found that having a TV in the bedroom and having no rules about viewing correlates with viewing more sexual content (Kim et al., 2006). Schools, too, need to be more sensitive to media in general and sex in the media specifically. Sex education programs should incorporate media literacy into their curricula, and schools need to teach and establish reasonable rules about online privacy, Internet use, and sexting (Strasburger, 2012b). Finally, law enforcement officials need to understand that sexting is a manifestation of poor judgment, not a crime (Draper, 2012; Hughes, 2011; Lithwick, 2009). A 2012 survey of more than 2,100 adults nationwide found great sympathy for a more rational approach to adolescents who sext (see Figure 5.22) (C. S. Mott Children’s Hospital, National Poll on Children’s Health, 2012).


Figure 5.22 Public support for youth sexting laws.

SOURCE: C. S. Mott Children’s Hospital, National Poll on Children’s Health (2012). Reprinted with permission.

8. More research. Many longitudinal studies now point to the media as one crucial factor in a teenager’s decision of when to have sexual intercourse. But the amount of research on sex and the media pales in comparison to the 3,500 studies done on children and media violence. Considerably more research needs to be funded, and such research will need to be interdisciplinary, using a variety of methods and a variety of populations, and will need to take into account developmental, gender, and ethnic differences (Shafer, A., Bobkowski, P., & Brown, J. D., 2013). For example:

How do different groups of children and teenagers view different sexual content? Do different groups use different types of media to find sexual content? Is that content interpreted differently? Are there developmental differences in how teens of different ages interpret sexual content? (A few preliminary studies of this kind have already been done [Aubrey et al., 2003; J. D. Brown & Schulze, 1990; Manganello et al., 2010; Rivadeneyra & Ward, 2005; Tolman, Kim, Schooler, & Sorsoli, 2007].)


Do teens from different ethnic groups seek out programming unique to their own ethnic group (J. D. Brown & Pardun, 2004)?

How do individuals negotiate sexual behavior in the media? What interpersonal contexts exist for sexual behavior? Do different media portray sexuality differently?

How do current media change teens’ knowledge about sex and sexuality, their emotions concerning sex, or their attitudes? Regular adolescent viewers of teen soap operas like Gossip Girl could be recruited and shown “future episodes” of their favorite program, which might be manipulated to show different messages, for example.

What, if any, are the behavioral effects of new media? Does posting sexual information on one’s social network profile or sexting have behavioral consequences (O’Sullivan, 2012)? For example, a new two-year study to be funded by the National Institutes of Health and conducted at the University of Dallas will capture and code the content of adolescent activity on Facebook (Nauert, 2012). Are the effects of Internet pornography the same as traditional (“tamer”) pornography? (Guy, Patton, & Kaldor, 2012; Strasburger, 2012a; Wright et al., 2012).

The barriers to doing this type of research are considerable (Huston et al., 1998; Strasburger, 1998). School systems and parents need to grant access to researchers, and foundations need to fund such efforts. Foundations need to recognize media research as a new and much-needed priority. In addition, society needs to accept the fact that teenagers should be able to give consent for such research on their own and that parents can be informed “passively” about ongoing studies (e.g., a letter explaining the research, along with the opportunity to withdraw the child if need be) rather than “actively” (e.g., having to send back signed permission forms) (Santelli, 1997; Strasburger, 1998).

Conclusion: Unanswered Questions Despite this discussion, not all media are unhealthy or irresponsible for young people. Some shows have dealt responsibly with the issue of teenage sexual activity and teenage pregnancy, from the original Beverly Hills,


90210, Dawson’s Creek, Felicity, and My So-Called Life to the more contemporary ER, Friday Night Lights, and Glee. Made-for-TV movies such as Babies Having Babies and Daddy have used extremely frank language to good, educational effect. Historically, the 1980s cop drama Cagney & Lacey contained one of the first instances of a TV mother talking to her son about responsibility and birth control. On St. Elsewhere, the only known mention of a diaphragm on prime-time TV was aired during the 1987–1988 season, although accomplishing this required that the user be the chief of obstetrics and gynecology. The new threat of AIDS in the 1980s brought with it a superb episode of L.A. Law during the 1987–1988 season, which discussed the risk of AIDS in heterosexual intercourse but also included good advice on birth control and limiting the number of sexual partners (see Strasburger, 1989). But these are all notable exceptions.

Sadly, as the years pass, the amount of suggestive and explicit sexual content on TV increases dramatically, but the amount of responsible sexual content does not. And, unfortunately, it has not been the tragedy of teenage pregnancy or the high rates of early adolescent sexual activity and STIs that have changed the network landscape, but paradoxically the apparent need to keep pace with the even sexier content on cable and premium channels and the Internet.

How do adolescents process the sexual content that they view? Do different ethnic groups interpret the same content differently? Can teenagers learn abstinence or the need to use birth control from what they view in the media? Would more widespread advertising of contraceptives and fewer ads for erectile dysfunction drugs make a significant dent in the U.S. teen pregnancy rate? Until the political and funding climate changes, and until adults understand that asking children and teenagers about sex will not provoke them into early sexual activity, we will simply have to rely on what research is available and speculate about many of these crucial issues. As one author notes,

I’ve often wondered what it would be like if we taught young people swimming the same way we teach sexuality. If we told them that swimming was an important adult activity, one they will all have to be skilled at when they grow up, but we never talked with them about it. We never showed them the pool. We just allowed them to stand outside closed doors and listen to all the splashing. Occasionally, they might catch a glimpse of partially-clothed people going in and out of the door to the pool and maybe they’d find a hidden book on the art of swimming, but when they asked a question about how swimming felt or what it was about, they would be greeted with blank or


embarrassed looks. Suddenly, when they turn 18 we would fling open the doors to the swimming pool and they would jump in. Miraculously, some might learn to tread water, but many would drown. (E. Roberts, 1983, p. 10)

Exercises 1. Taste. When we talk about “taste,” whose taste do we mean? Ours?

Yours? Hollywood’s? This is a recurring problem in discussing the media and one we do not take lightly. In this volume, we have erred on the side of public health and psychology in discussing what is questionable taste and what represents “good” versus “bad” programming. Although we have tried to give examples, we have left the discussion purposefully vague because we acknowledge that taste can vary considerably. But when it comes to “bad” taste or “questionable” programming that is unhealthy, we would tend to agree with a paraphrase of Supreme Court Justice Potter Stewart’s definition of pornography: “We know it when we see it.”

a. Should the media be criticized on grounds of taste? b. If so, whose taste should be used as the “gold standard”? Is an

objective standard possible? c. In making judgments about taste, what sociocultural factors enter

the discussion? d. “Push the envelope” seems to be the new guiding principle for

Hollywood writers. The writer of the hit shows 2 Broke Girls and Whitney is Whitney Cummings, who half jokingly told a New York Times reporter, “If one day passes without me writing any more vagina jokes, my career is blown” and noted that “our tolerance for what is edgy is changing” (M. E. Williams, 2011). Is it? Is this a case of the media leading society or mirroring it?

2. Prosocial content. How would you go about making a prosocial soap opera that would appeal to teenagers and young adults and contain sexually responsible language, discussions, and behavior but not lose the audience with a “goody-two-shoes” program?

3. Sex education. For the first decade in the new millennium, the federal government only funded abstinence-only sex education. More than $1 billion has been spent on such sex education (Sexuality Information and Education Council of the United States, 2006), despite the lack of


any convincing evidence that abstinence-only sex education actually works (Government Accountability Office, 2006; Santelli et al., 2006; Trenholm et al., 2007). Do you think abstinence-only sex ed is effective when the media are apparently not “abstinence only”?

4. Media literacy. Is there a media literacy approach to sex education that might work to decrease the impact of media on sexual attitudes and beliefs? What components would it have (see Chapter 12)? How would sex education teachers be able to avoid “family values” issues if they discussed programming with sexual content?

5. Sexuality research. How could research be sensitively designed to assess what children learn from sexual content in the media?

6. Contraception and erectile dysfunction medication ads. Figure 5.23 shows two actual print ads for condoms. Figure 5.19 shows two ads for emergency contraception. Is there a difference between advertising “regular” birth control and advertising emergency contraception? For which magazines would each be appropriate? Do the ads target different audiences? What other possibilities can you think of that might appeal specifically to all teenagers? To teenagers who are African American or Hispanic? To males? To females? How do these ads differ from other, “mainstream” ads? Are these ads effective?

Figure 5.23 Condom ads.

In June 2007, both CBS and FOX rejected an ad for Trojans because “advertising must stress health-related uses rather than the


prevention of pregnancy,” according to one network executive (Newman, 2007). The ad ( v=U6krr40mdHM) shows women at a bar, surrounded by pigs. One pig goes to use the bathroom, returns with a condom he’s purchased, and is magically transformed into an attractive man. The tagline is “Evolve: Use a condom every time.” Do you think this ad is creative? Offensive? Effective?

In December 2006, an ad for Viagra aired at around 9 p.m. during a G-rated movie, Prancer, about a young girl who nurses one of Santa’s reindeers back to health; a Levitra ad appeared during an afternoon broadcast of Pee-wee’s Big Adventure, and an ad for Cialis appeared during an early-evening showing of Miracle on 34th Street (A. Johnson, 2007). In 2009, Representative Jim Moran (D-Va.) introduced H.R. 2175, which would prohibit any ED ads from airing on broadcast radio or TV between 6 a.m. and 10 p.m. (Ruff, 2009). The American Academy of Pediatrics has called for a voluntary ban on erectile dysfunction ads during prime-time TV (Roan, 2010). If you were in Congress, would you vote for such legislation?

7. HIV/AIDS prevention. You are a school principal and are asked to view a sex ed video for possible inclusion in the curriculum. In it, a terminally ill AIDS patient, cachectic and stripped to the waist, stares straight at the camera and says, “Kids, if you have sex once, with the wrong person, you may die.” Your brother died from AIDS a year ago, and this video affects you deeply. Should you approve it for use in the classroom?

8. The Internet. (1) In Shanghai, China, the government is providing sex education via the Internet (Lou, Zhao, Gao, & Shah, 2006). Is this a good idea? Can you see any drawbacks? (2) In one study of 1,500 Internet users, ages 10 to 17 years, 42% reported exposure to online pornography (two-thirds reported it was unwanted) (Wolak et al., 2007). What solutions exist to shield children and teens from online pornography? Effective December 6, 2011, the Internet’s oversight agency instituted an “.xxx” domain for pornography on the Web. Domains are for sale for $60 each, but adult sites are not required to use the domain (Pachal, 2011). Will that work?

9. Celebrities. In March 2007, the Associated Press initiated a self- imposed week-long ban on reporting anything about Paris Hilton (“AP: We Ignored,” 2007). Was that a reasonable thing to do? A month earlier, Newsweek’s cover story was “Girls Gone Wild: What


Are Celebs Teaching Kids?” (Deveny & Kelley, 2007). Find the story and discuss it. Why are Paris Hilton and Kim Kardashian celebrities, and should they be? What do you think of Lady Gaga as a role model for children and teenagers? How does someone become famous in American culture?

10. Young girls. Recently, the American Psychological Association issued its report on the increasing sexualization of young girls (Zurbriggen et al., 2010). In covering the story, one news reporter wrote, “Ten-year-old girls can slide their low-cut jeans over ‘eye- candy’ panties. French maid costumes, garter belt included, are available in preteen sizes. Barbie now comes in a ‘bling-bling’ style, replete with halter top and go-go boots. . . . American girls, say experts, are increasingly being fed a cultural catnip of products and images that promote looking and acting sexy” (Weiner, 2007, p. HE01). Is this a relatively new problem or an ongoing one? Read the executive summary of the report and see if you agree with the many recommendations ( How easy would it be to change the portrayal of sexuality in American society, and what will it take to do so?

11. Teen pregnancy and abortion. In 2006 and 2007, several movies seemed to portray teen pregnancy and single motherhood in a new light. According to one prominent columnist, “by some screenwriter consensus, abortion has become the right-to-choose that’s never chosen. In Knocked Up, it was referred to as ‘shmashmortion.’ In Juno, the abortion clinic looks like a punk-rock tattoo parlor” (Goodman, 2008, January 5, p. A8). Other observers agree (Rickey, 2007, p. B8). Do you think this is a new trend? Is it “healthy,” and will it have real-life repercussions?

12. Preventing teen pregnancy. In 2009, officials in Leicester, England (about 100 miles north of London), produced a gritty video simulation of a schoolyard birth ( v=frHOZn3tpdQ) in an attempt to decrease the teen pregnancy rate in the area, which was eight times the national average. The video was recorded on a cell phone and ends with the words, “Now what you expected? Being a teenage parent might not be either.” Officials made no apologies for the graphic video. “Hairs on the back of my neck do stand up, but you know teenage pregnancy is a hard-hitting issue and we’ve got lots of teenage pregnancies in our city,” one official was quoted as saying (Zuckerbrod, 2009). Was this a good


idea? Do “scare tactics” work with adolescents? Can you think of alternative media approaches to the problem?


Abma, J. C., Martinez, G. M., & Copen, C. E. (2010). Teenagers in the United States: Sexual activity, contraceptive use, and childbearing, National Survey of Family Growth 2006–2008. Vital Health Statistics, 23(30), 1–47.

Advocates for Youth. (2011). Adolescent sexual health in Europe and the U.S. Retrieved from

Agha, S., & Meekers, D. (2010). Impact of an advertising campaign on condom use in urban Pakistan. Studies in Family Planning, 41, 277–290.

Agovino, T. (2007, January 24). Levitra, Viagra running new ad campaigns. Retrieved from dyn/content/article/2006/05/02/AR2006050200857.html

Alexy, E. M., Burgess, A. W., & Prentky, R. A. (2009). Pornography use as a risk marker for an aggressive pattern of behavior among sexually reactive children and adolescents. Journal of the American Psychiatric Nurses Association, 14, 442–453.

Alter, J. (1994, January 17). The power to change what’s “cool.” Newsweek, p. 23.

American Pie 2: Editorial reviews [Product description]. (n.d.). Retrieved May 24, 2006, from

Ansen, D. (1999, September 13). A handful of tangos in Paris. Newsweek, p. 66.

AP: We ignored Paris Hilton. (2007, March 4). Retrieved from Armstrong, J. (2011, January 28). Gay teens on TV. Entertainment Weekly,

1139, 34-41. Arnett, J. J. (2002). The sounds of sex: Sex in teens’ music and music

videos. In J. D. Brown, J. R. Steele, & K. Walsh-Childers (Eds.), Sexual teens, sexual media (pp. 253–264). Mahwah, NJ: Lawrence Erlbaum.

Ashby, S. L., Arcari, C. M., & Edmonson, M. B. (2006). Television viewing and risk of sexual initiation by young adolescents. Archives of Pediatrics and Adolescent Medicine, 160, 375–380.


Ashby, S. L., & Rich, M. (2005). Video killed the radio star: The effects of music videos on adolescent health. Adolescent Medicine: State of the Art Reviews, 16, 371–393.

Associated Press & MTV. (2009, September 23). AP-MTV digital abuse study [Executive summary]. Retrieved from AP_Digital_Abuse_Study_Executive_Summary.pdf

Aubrey, J. S., Behm-Morawitz, E., & Kim, K. (2013, in press). Understanding the effects of MTV’s 16 and Pregnant on adolescent girls’ beliefs, attitudes, and behavioral intentions toward teen pregnancy. Journal of Health Communication.

Aubrey, J. S., Harrison, K., Kramer, L., & Yellin, J. (2003). Variety versus timing: Gender differences in college students’ sexual expectations as predicted by exposure to sexually oriented television. Communication Research, 30, 432–460.

Bagdasarov, Z., Greene, K., Banerjee, S. C., Krcmar, M., Yanovitzky, I., & Ruginyte, D. (2010). I am what I watch: Voyeurism, sensation seeking, and television viewing patterns. Journal of Broadcasting and Electronic Media, 54, 299–315.

Baird, J. (2010, October 4). The shame of family films. Newsweek. Retrieved from are-so-sexist.html

Ballam, S. M., & Granello, P. F. (2011). Confronting sex in the media: Implications and counseling recommendations. Sex Roles, 19, 421–426.

Batchelor, S. A., Kitzinger, J., & Burtney, E. (2004). Representing young people’s sexuality in the “youth” media. Health Education Research, 19, 669–676.

Battaglio, S. (2010, October 10). The future of TV is now. TV Guide, pp. 22–23.

Baumgartner, S. E., Sumter, S. R., Peter, J., & Valkenburg, P. M. (2012). Identifying teens at risk: Developmental pathways of online and offline sexual risk behavior. Pediatrics, 130, 1–8.

Bayer HealthCare Pharmaceuticals. (2011). “Clueless or clued up: Your right to be informed about contraception” media report. Retrieved from BFFC882F8333/5706/CluelessOrCluedUpReport.pdf

Beckett, M. K., Elliott, M. N., Martino, S., Kanouse, D. E., Coronoa, R.,


Klein, D. J., & Schuster, M. A. (2010). Timing of parent and child communication about sexuality relative to children’s sexual behaviors. Pediatrics, 125, 34-42.

Bennett, L. (2003). TV commercials exploit, ridicule or sideline women [Press release]. Retrieved from 2003/superbowl.html

Bersamin, M. M., Bourdeau, B., Fisher, D. A., & Grube, J. W. (2010). Television use, sexual behavior, and relationship status at last oral sex and vaginal intercourse. Sexuality and Culture, 14, 157–168.

Bersamin, M. M., Todd, M., Fisher, D. A., Hill, D. L., Grube, J. W., & Walker, S. (2008). Parenting practices and adolescent sexual behavior: A longitudinal study. Journal of Marriage and Family, 70, 97–112.

Blake, S. M., Ledsky, R., Goodenow, C., Sawyer, R., Lohrmann, D., & Windsor, R. (2003). Condom availability programs in Massachusetts high schools: Relationships with condom use and sexual behavior. American Journal of Public Health, 93, 955–962.

Bleakley, A., Hennessy, M., & Fishbein, M. (2006). Public opinion on sex education in US schools. Archives of Pediatrics and Adolescent Medicine, 160, 1151–1156.

Bleakley, A., Hennessy, M., & Fishbein, M. (2011). A model of adolescents’ seeking of sexual content in their media choices. Journal of Sex Research, 48, 309–315.

Bleakley, A., Hennessy, M., Fishbein, M., & Jordan A. (2008). It works both ways: The relationship between exposure to sexual content in the media and adolescent sexual behavior. Media Psychology, 11, 443–461.

Bleakley, A., Hennessy, M., Fishbein, M., & Jordan, A. (2009). How sources of sexual information relate to adolescents’ beliefs about sex. American Journal of Health Behavior, 33, 37–48.

Bleakley, A., Jamieson, P. E., & Romer, D. (2012). Trends in sexual and violent content by gender in top-grossing U.S. films, 1950–2006. Journal of Adolescent Health, 51, 73–79.

Bobkowski, P. S., Brown, J. D., & Neffa, D. R. (2012). “Hit me up and we can get down”: US youths’ risk behaviors and sexual self-disclosure in MySpace profiles. Journal of Children and Media, 6, 119–134.

Borzekowski, D. L. G., McCarthy, C., & Rosenfeld, W. (2012). Ten years of A case study of an adolescent health website. Pediatric Clinics of North America, 59, 717–728.

Boyar, R., Levine, D., & Zensius, N. (2011). TECHsex USA: Youth


sexuality and reproductive health in the digital age. Oakland, CA: ISIS. Braun, R., Howard, H., & Madsen, A. (2010, February 26–27).

Implementing a text-message-based sexual health information and clinic referral service for California youth. Paper presented at SexTech conference, San Francisco, CA.

Braun-Courville, D. K., & Rojas, M. (2009). Exposure to sexually explicit Web sites and adolescent sexual attitudes and behaviors. Journal of Adolescent Health, 45, 156–162.

Brenton, S., & Cohen, R. (2003). Shooting people: Adventures in reality TV. New York, NY: Verso.

Bridges, A. J., Wosnitzer, R., Scharrer, E., Sun, C., & Liberman, R. (2010). Aggression and sexual behavior in best-selling pornography videos: A content analysis update. Violence Against Women, 16, 1065–1085.

Brodesser-akner, C. (2007, September 17). Sex on TV is OK as long as it’s not safe. Advertising Age. Retrieved from

Brodie, M., Foehr, U., Rideout, V., Baer, N., Miller, C., Flournoy, R., & Altman, D. (2001). Communicating health information through the entertainment media. Health Affairs, 20, 1–8.

Brown, D., & Bryant, J. (1989). Uses of pornography. In D. Zillmann & J. Bryant (Eds.), Pornography: Research advances and policy considerations (pp. 3–24). Hillsdale, NJ: Lawrence Erlbaum.

Brown, J. D. (2006). Media literacy has potential to improve adolescents’ health. Journal of Adolescent Health, 39, 459–460.

Brown, J. D. (Ed). (2008). Managing the media monster: The influence of media (from television to text messages) on teen sexual behavior and attitudes. Washington, DC: National Campaign to Prevent Teen and Unplanned Pregnancy.

Brown, J. D., Halpern, C. T., & L’Engle, K. L. (2005). Mass media as a sexual super peer for early maturing girls. Journal of Adolescent Health, 36, 420–427.

Brown, J. D., & L’Engle, K. L. (2009). X-rated: Sexual attitudes and behaviors associated with U.S. early adolescents’ exposure to sexually explicit media. Communication Research, 36, 129–151.

Brown, J. D., L’Engle, K. L., Pardun, C. H., Guo, G., Kenneavy, K., & Jackson, C. (2006). Sexy media matter: Exposure to sexual content in music, movies, television, and magazines predicts Black and White adolescents’ sexual behavior. Pediatrics, 117, 1018–1027.


Brown, J. D., & Pardun, C. J. (2004). Little in common: Racial and gender differences in adolescents’ television diets. Journal of Broadcasting and Electronic Media, 48, 266–278.

Brown, J. D., & Schulze, L. (1990). The effects of race, gender, and fandom on audience interpretations of Madonna’s music videos. Journal of Communication, 40, 88–102.

Brown, J. D., & Steele, J. R. (1995). Sex and the mass media. Menlo Park, CA: Kaiser Family Foundation.

Brown, J. D., & Strasburger, V. C. (2007). From Calvin Klein, to Paris Hilton and MySpace: Adolescents, sex & the media. Adolescent Medicine: State of the Art Reviews, 18, 484–507.

Buhi, E. R., Daley, E. M., Oberne, A., Smith, S. A., Schneider, T., & Furhrmann, H. J. (2010). Quality and accuracy of sexual health information Web sites visited by young people. Journal of Adolescent Health, 47, 206–208.

Bull, S. S., Levine, D. K., Black, S. R., Schmiege, S. J., & Santelli, J. (2012). Social media–delivered sexual health intervention: A cluster randomized controlled trial. American Journal of Preventive Medicine, 43, 467–474.

Bull, S. S., Posner, S. F., Ortiz, C., Beaty, B., Benton, K., Lin, L., . . . Evans, T. (2008). POWER for reproductive health: Results from a social marketing campaign promoting female and male condoms. Journal of Adolescent Health, 43, 71–78.

Calzo, M. A., & Ward, L. M. (2009). Media exposure and viewers’ attitudes toward homosexuality: Evidence for mainstreaming or resonance? Journal of Broadcasting and Electronic Media, 53, 280–299.

Carpentier, F. D., Knobloch-Westerwick, S., & Blumhoff, A. (2007). Naughty versus nice: Pop music influences on perceptions of romantic partners. Media Psychology, 9, 1–17.

Carroll, J. S., Padilla-Walker, L. M., Nelson, L. J., Olson, C. D., Barry, C. M., & Madsen, S. D. (2008). Generation XXX: Pornography acceptance and use among emerging adults. Journal of Adolescent Research, 23, 6– 30.

Carroll, L. (2010, September 27). Erectile dysfunction ads too hot for primetime? Retrieved from childrens_health/t/erectile-dysfunction-ads-too-hot-primetime/#

Carson, V., Pickett, W., & Janssen, I. (2011). Screen time and risk behaviors


in 10- to 16-year-old Canadian youth. Preventive Medicine, 52, 99–103. Carter, B. (2011a, September 21). This year’s hot TV trend is anatomically

correct. New York Times. Retrieved from trend-is-a-word.html?pagewanted=all

Carter, B. (2010b, September 13). Tired of reality TV, but still tuning in. New York Times. Retrieved from

Case, T. (2007, February 26). Trouble in teen land. Retrieved from miscellaneous-business/4845708-1.html

Cavazos-Rehg, P. A., Krauss, M. J., Spitznagel, E. L., Iguchi, M., Schootman, M., Cottler, L., . . . Bierut, L. J. (2012). Associations between sexuality education in schools and adolescent birthrates. Archives of Pediatrics and Adolescent Medicine, 166, 134–140.

Centers for Disease Control and Prevention. (1993). Sexual risk behaviors of STD clinic patients before and after Earvin “Magic” Johnson’s HIV- infection announcement—Maryland, 1991–1992. Morbidity and Mortality Weekly Report, 42, 45–48.

Centers for Disease Control and Prevention. (2011a). Sexually transmitted disease surveillance 2010. Atlanta, GA: U.S. Department of Health and Human Services.

Centers for Disease Control and Prevention. (2011b). Vital signs: Teen pregnancy—United States, 1991–2009. Morbidity and Mortality Weekly Report, 60(13), 414–420.

Centers for Disease Control and Prevention. (2012a). Prepregnancy contraceptive use among teens with unintended pregnancies resulting in live births—Pregnancy Risk Assessment Monitoring System (PRAMS), 2004–2008. Morbidity and Mortality Weekly Report, 61, 25–29.

Centers for Disease Control and Prevention. (2012b). Youth Risk Behavior Surveillance—United States, 2011. Morbidity and Mortality Weekly Report, 61(SS-4), 1–162.

Chandra, A., Martino, S. C., Collins, R. L., Elliott, M. N., Berry, S. H., Kanouse, D. E., & Miu, A. (2008). Does watching sex on television predict teen pregnancy? Findings from a national longitudinal survey of youth. Pediatrics, 122, 1047–1054.

Chandra, A., Mosher, W. D., Copen, C., & Sionean, C. (2011). Sexual behavior, sexual attraction, and sexual identity in the United States: Data


from the 2006–2008 National Survey of Family Growth. National Health Statistic Reports, 36, 1–36.

Cheng, Y., Lou, C., Gao, E., & Zabin, L. S. (2013, in press). Unmarried adolescents’ and youth’s sex-related knowledge, attitudes and behaviors in three Asian cities: The role of media variables. Journal of Adolescent Health.

Chia, S. C. (2006). How peers mediate media influence on adolescents’ sexual attitudes and sexual behavior. Journal of Communication, 56, 585–606.

Christenson, P., & Ivancin, M. (2006). The “reality” of health: Reality television and the public health. Menlo Park, CA: Kaiser Family Foundation.

Clarke, J. N. (2010). The paradoxical portrayal of the risk of sexually transmitted infections and sexuality in US magazines Glamour and Cosmopolitan 2000–2007. Health, Risk and Society, 12, 560–574.

Clark-Flory, T. (2012, April 1). Facebook: The next tool in fighting STDs. Salon. Retrieved from

Collins, R. L., Elliott, M. N., Berry, S. H., Kanouse, E., & Hunter, S. B. (2003). Entertainment television as a healthy sex educator: The impact of condom-efficacy information in an episode of Friends. Pediatrics, 112, 1115–1121.

Collins, R. L., Elliott, M. N., Berry, S. H., Kanouse, D. E., Kunkel, D., Hunter, S. B., & Miu, A. (2004). Watching sex on television predicts adolescent initiation of sexual behavior. Pediatrics, 114, e280–e289.

Collins, R. L., Martino, S. C., & Shaw, R. (2011). Influence of new media on adolescent sexual health: Evidence and opportunities. Santa Monica, CA: RAND.

Comstock, G., & Strasburger, V. C. (1993). Media violence: Q&A. Adolescent Medicine: State of the Art Reviews, 4, 495–510.

Conrad, M. A., Dixon, T. L., & Zhang, Y. (2009). Controversial rap themes, gender portrayals and skin tone distortion: A content analysis of rap music videos. Journal of Broadcasting and Electronic Media, 53, 134– 156.

Cope-Farrar, K. M., & Kunkel, D. (2002). Sexual messages in teens’ favorite prime-time TV programs. In J. D. Brown, J. R. Steele, & K. Walsh-Childers (Eds.), Sexual teens, sexual media (pp. 59–78). Mahwah, NJ: Lawrence Erlbaum.


Copen, C. E., Chandra, A., & Martinez, G. (2012). Prevalence and timing of oral sex with opposite-sex partners among females and males aged 15-24 years: United States, 2007–2010 (National Health Statistics Report No. 56). Hyattsville, MD: National Center for Health Statistics.

Council on Communications and Media. (2009). Impact of music, music lyrics, and music videos on children and youth. Pediatrics, 124, 1488– 1494.

Council on Communications and Media. (2010). Media education. Pediatrics, 126, 1012–1017.

Cox Communications, National Center for Missing & Exploited Children. (2009, May). Teen online & wireless safety survey: Cyberbullying, sexting, and parental controls. Atlanta, GA: Author.

Coy, M., & Horvath, M. A. H. (2011). Lads’ mags, young men’s attitudes towards women and acceptance of myths about sexual aggression. Feminism and Psychology, 21, 144–150.

Coyne, S. M., & Archer, J. (2004). Indirect aggression in the media: A content analysis of British television programs. Aggressive Behavior, 30, 254–271.

Coyne, S. M., Robinson, S. L., & Nelson, D. A. (2010). Does reality backbite? Physical, verbal, and relational aggression in reality television programs. Journal of Broadcasting and Electronic Media, 54, 282–298.

C. S. Mott Children’s Hospital, National Poll on Children’s Health. (2012). For youth sexting: Public supports education, not criminal charges. Retrieved from public-supports-education-not-criminal-charges

DeJong, W., Wolf, R. C., & Austin, S. B. (2001). U.S. federally funded television public service announcements (PSAs) to prevent HIV/AIDS: A content analysis. Journal of Health Communication, 6, 249–262.

Delgado, H., Austin, S. B., Rich, M., & Bickham, D. (2009, May 4). Exposure to adult-targeted television and movies during childhood increases risk of initiation of early intercourse [Abstract]. Presented at the Pediatric Academic Societies meeting, Baltimore, MD.

Deveny, K., & Kelley, R. (2007, February 12). Girls gone wild: What are celebs teaching kids? Newsweek, pp. 40–47.

Donnerstein, E., Linz, D., & Penrod, S. (1987). The question of pornography: Research findings and policy implications. New York, NY: Free Press.

Downs, J. S., Murray, P. J., Bruine de Bruin, W., Penrose, J., Palmgren, C.,


& Fischhoff, B. (2004). Interactive video behavioral intervention to reduce adolescent females’ STD risk: A randomized controlled trial. Social Science and Medicine, 59, 1561–1572.

Doyle, S. (2010, September 20). Easy A: A teen sex comedy, minus the sex. Atlantic. Retrieved from sex-comedy-minus-the-sex/63249/

Draper, N. R. A. (2012). Is your teen at risk? Discourses of adolescent sexting in United States television news. Journal of Children and Media, 6, 221–236.

Duffy, M., & Gotcher, J. M. (1996). Crucial advice on how to get the guy: The rhetorical vision of power and seduction in the teen magazine YM. Journal of Communication, 20, 32–48.

DuRant, R. H., Wolfson, M., LaFrance, B., Balkrishnan, R., & Altman, D. (2006). An evaluation of a mass media campaign to encourage parents of adolescents to talk to their children about sex. Journal of Adolescent Health, 38, 298e1–298e9.

Elkind, D. (1984, November/December). Teenage thinking: Implications for health care. Pediatric Nursing, pp. 383–385.

Elkind, D. (1993). Parenting your teenager in the 90’s. Rosemont, NJ: Modern Learning Press.

Emmers-Sommer, T. M., Pauley, P., Hanzal, A., & Triplett, L. (2006). Love, suspense, sex, and violence: Men’s and women’s film predilections, exposure to sexually violent media, and their relationship to rape myth acceptance. Sex Roles, 55, 311–320.

Escobar-Chaves, S. L., Tortolero, S. R., Markham, C. M., Low, B. J., Eitel, P., & Thickstun, P. (2005). Impact of the media on adolescent sexual attitudes and behaviors. Pediatrics, 116, 303–326.

Espey, E., Cosgrove, E., & Ogburn, T. (2007). Family planning American style: Why it’s so hard to control birth in the US. Obstetrics and Gynecology Clinics of North America, 34, 1–17.

Evans, W. D., Davis, K. C., Umanzor, C., Patel, K., & Khan, M. (2011). Evaluation of sexual communication message strategies. Reproductive Health, 8, 15.

Eyal, K., & Kunkel, D. (2008). The effects of sex in television drama shows on emerging adults’ sexual attitudes and moral judgments. Journal of Broadcasting and Electronic Media, 52, 161–181.

Eyal, K., Kunkel, D., Biely, E. N., & Finnerty, K. L. (2007). Sexual


socialization messages on television programs most popular among teens. Journal of Broadcasting and Electronic Media, 51, 316–336.

Fard, M. F. (2012, July 16). Web videos address questions on sex, birth control, sexually transmitted diseases. Washington Post. Retrieved from address-questions-on-sex-birth-control-sexually-transmitted- diseases/2012/07/16/gJQA6Oi5oW_story.html

Farrar, K. M. (2006). Sexual intercourse on television: Do safe sex messages matter? Journal of Broadcasting and Electronic Media, 50, 635–650.

Ferguson, C. J., Salmond, K., & Modi, K. (2013). Reality television predicts both positive and negative outcomes for adolescent girls. Journal of Adolescent Health, published online Jan. 7. DOI = 10.1016/j.jpeds.2012.11.037.

Ferguson, T., Berlin, J., & Noles, E. (2005). Variation in the application of the “promiscuous female” female stereotype and the nature of the application domain: Influences on sexual harassment judgments after exposure to The Jerry Springer Show. Journal of Broadcasting and Electronic Media, 50, 635–650.

Ferris, A. L., Smith, S. W., Greenberg, B. S., & Smith, S. L. (2007). The content of reality dating shows and viewer perceptions of dating. Journal of Communication, 57, 490–510.

Finer, L. B., & Kost, K. (2011). Unintended pregnancy rates at the state level. Perspectives on Sexual and Reproductive Health, 43, 78–87.

Fisher, D. A., Hill, D. L., Grube, J. W., Bersamin, M. M., Walker, S., & Gruber, E. L. (2009). Televised sexual content and parental mediation: Influences on adolescent sexuality. Media Psychology, 12, 121–147.

Fischer, P., & Greitemeyer, T. (2006). Music and aggression: The impact of sexual-aggressive song lyrics on aggression-related thoughts, emotions, and behavior toward the same and opposite sex. Personality and Social Psychology Bulletin, 32, 1165–1176.

Fisher, D. A., Hill, D. L., Grube, J. W., Bersamin, M. M., Walker, S., & Gruber, E. L. (2009). Televised sexual content and parental mediation: Influences on adolescent sexuality. Media Psychology, 12, 121–147.

Fisher, L. (2010, December 23). MTV airing teen abortion special, “No Easy Decision.” ABC News. Retrieved from easy-decison/story?id=12458576


Flood, M. (2009, July 11). The extent of exposure to pornography among children and young people. XY Online. Retrieved from children-and-young-people

Folb, K. L. (2000). “Don’t touch that dial!” TV as a—what!?—positive influence. SIECUS Report, 28, 16–18.

Fouts, G., & Inch, R. (2005). Homosexuality in TV situation comedies. Journal of Homosexuality, 49, 35–45.

Furstenberg, F. F., Jr., Geitz, L. M., Teitler, J. O., & Weiss, C. C. (1997). Does condom availability make a difference? An evaluation of Philadelphia’s health resource centers. Family Planning Perspectives, 29, 123–127.

Gay & Lesbian Alliance Against Defamation. (2011). 2011: Where are we on TV? Los Angeles, CA: Author.

Glieberman, O. (1999, July 16). Virgin megascore. Entertainment Weekly, pp. 43–44.

Goodman, E. (2008, January 5). Real teen pregnancies don’t have Hollywood ending. Albuquerque Journal, p. A8.

Gordon-Messer, D., Bauermeister, J.A., Grodzinski, A., & Zimmerman, M. (2012). Sexting among young adults. Journal of Adolescent Health. doi: 10.1016/j.jadohealth.2012.05.013

Gottfried, J. A., Vaala, S. E., Bleakley, A., Hennessy, M., & Jordan, A. (2011). Does the effect of exposure to TV sex on adolescent sexual behavior vary by genre? Communication Research. doi: 10.1177/0093650211415399

Government Accountability Office. (2006, October). Efforts to assess the accuracy and effectiveness of federally funded programs. GAO Highlights. Retrieved from– 87

Greenberg, B. S. (1994). Content trends in media sex. In D. Zillmann, J. Bryant, & A. C. Huston (Eds.), Media, children, and the family: Social scientific, psychodynamic, and clinical perspectives (pp. 165–182). Hillsdale, NJ: Lawrence Erlbaum.

Greenberg, B. S., & Busselle, R. W. (1994). Soap operas and sexual activity. Menlo Park, CA: Kaiser Family Foundation.

Greenberg, B. S., Siemicki, M., Dorfman, S., Heeter, C., & Stanley, C. (1993). Sex content in R-rated films viewed by adolescents. In B. S. Greenberg, J. D. Brown, & N. L. Buerkel-Rothfuss (Eds.), Media, sex,


and the adolescent (pp. 45–58). Cresskill, NJ: Hampton. Greenberg, B. S., Stanley, C., Siemicki, M., Heeter, C., Soderman, A., &

Linsangan, R. (1993). Sex content on soaps and prime-time television series most viewed by adolescents. In B. S. Greenberg, J. D. Brown, & N. L. Buerkel-Rothfuss (Eds.), Media, sex and the adolescent (pp. 29– 44). Cresskill, NJ: Hampton.

Greenfield, P., & Beagles-Roos, J. (1988). Television vs. radio: The cognitive impact on different socio-economic and ethnic groups. Journal of Communication, 38, 71–92.

Greenfield, P. M., Bruzzone, L., Koyamatsu, K., Satuloff, W., Nixon, K., Brodie, M., & Kingsdale, D. (1987). What is rock music doing to the minds of our youth? A first experimental look at the effects of rock music lyrics and music videos. Journal of Early Adolescence, 7, 315–329.

Guttmacher, S., Lieberman, L., Ward, D., Freudenberg, N., Radosh, A., & DesJarlais, D. (1997). Condom availability in New York City public high schools: Relationships to condom use and sexual behavior. American Journal of Public Health, 87, 1427–1433.

Gunasekera, H., Chapman, S., & Campbell, S. (2005). Sex and drugs in popular movies: An analysis of the top 200 films. Journal of the Royal Society of Medicine, 9, 464–470.

Guse, K., Levine, D., Martins, S., Lira, A., Gaarde, J., Westmorland, W., & Gilliam, M. (2012). Interventions using new digital media to improve adolescent sexual health: A systematic review. Journal of Adolescent Health, 51, 535–543.

Guy, R. J., Patton, G. C., & Kaldor, J. M. (2012). Internet pornography and adolescent health. Medical Journal of Australia, 196, 546–547.

Haag, P. (1999). Voices of a generation: Teenage girls on sex, school, and self. Washington, DC: American Association of University Women Educational Foundation.

Haffner, D. W., & Kelly, M. (1987, March/April). Adolescent sexuality in the media. SIECUS Report, pp. 9–12.

Hald, G. M., & Malamuth, N. M. (2008). Self-perceived effects of pornography consumption. Archives of Sexual Behavior, 37, 614–625.

Hald, G. M., Malamuth, N. M., & Yuen, C. (2010). Pornography and attitudes supporting violence against women: Revisiting the relationship in nonexperimental studies. Aggressive Behavior, 36, 14–20.

Hall, P. C., West, J. H., & Hill, S. (2011). Sexualization in lyrics of popular music from 1959 to 2009: Implications for sexuality educators. Sexuality


and Culture. Retrieved from

Halpern, C.T., & Haydon, A. A. (2012). Sexual timetables for oral-genital, vaginal, and anal intercourse: Sociodemographic comparisons in a nationally representative sample of adolescents. American Journal of Public Health, 102, 1221–1228.

Halpern-Felsher, B. L., Cornell, J. L., Kropp, R. Y., & Tschann, J. M. (2005). Oral versus vaginal sex among adolescents: Perceptions, attitudes, and behaviors. Pediatrics, 115, 845–851.

Hamilton, B. E., & Ventura, S. J. (2012). Birth rates for U.S. teenagers reach historic lows for all age and ethnic groups (NCHS Data Brief No. 89). Hyattsville, MD: National Center for Health Statistics.

Harris, L., & Associates. (1987). Attitudes about television, sex and contraception advertising. New York, NY: Planned Parenthood Federation of America.

Hatoum, I. J., & Belle, D. (2004). Mags and abs: Media consumption and bodily concerns in men. Sex Roles, 7, 397–407.

Heintz-Knowles, K. E. (1996). Sexual activity on daytime soap operas: A content analysis of five weeks of television programming. Menlo Park, CA: Kaiser Family Foundation.

Hennessy, M., Bleakley, A., Fishbein, M., & Jordan, A. (2009). Estimating the longitudinal association between adolescent sexual behavior and exposure to sexual media content. Journal of Sex Research, 46, 1–11.

Herd, D. A. (2009). Changes in the prevalence of violent rap song lyrics 1979–1997. Journal of Public Health Policy, 30, 395–406.

Hickman, M. (2010, March 17). Condom TV ads get prime-time all-clear. Independent. Retrieved from get-primetime-allclear-1922379.html

Hill, A. (2005). Reality TV: Audiences and popular factual television. Oxford, UK: Routledge.

Hobbs, D. R., & Gallup, G. G., Jr. (2011). Songs as a medium for embedded reproductive messages. Evolutionary Psychology, 9, 390–416.

Hoffman, J. (2011a, April 10). Fighting teenage pregnancy with MTV stars as Exhibit A. New York Times. Retrieved from pagewanted=all

Hoffman, J. (2011b, December 31). Sex education gets directly to youths,


via text. New York Times. Retrieved from online-and-in-texts.html

Howe, A., Owen-Smith, V., & Richardson, J. (2002). The impact of a television soap opera on the NHS Cervical Screening Programme in the north west of England. Journal of Public Health Medicine, 24, 299–304.

Hughes, S. A. (2011, June 6). Sexting teens need education, not jail, New York lawmakers say. Washington Post. Retrieved from education-not-jail-new-york-lawmakers- say/2011/06/06/AGsayOKH_blog.html

Huntemann, N., & Morgan, M. (2012). Media and identity development. In D. G. Singer & J. L. Singer (Eds.), Handbook of children and the media (2nd ed., pp. 303–319). Thousand Oaks, CA: Sage.

Huston, A. C., Wartella, E., & Donnerstein, E. (1998). Measuring the effects of sexual content in the media: A report to the Kaiser Family Foundation. Menlo Park, CA: Kaiser Family Foundation.

Jacobs, A. J., & Shaw, J. (1999, April 2). Virgin spring. Entertainment Weekly, pp. 10–11.

Jemmott, J. B., Jemmott, L. S., & Fong, G. T. (2010). Efficacy of a theory- based abstinence-only intervention over 24 months. Archives of Pediatrics and Adolescent Medicine, 164, 152–159.

Jensen, R. (2007). Getting off: Pornography and the end of masculinity. Cambridge, MA: South End Press.

Johnson, A. (2007, February 16). New impotence ads draw fire—just like the old ones. Wall Street Journal, p. B1.

Johnson, K. R., & Holmes, B. M. (2009). Contradictory messages: A content analysis of Hollywood-produced romantic comedy feature films. Communication Quarterly, 57, 352–373.

Jones, L. M., Mitchell, K. J., & Finkelhor, D. (2012). Trends in youth Internet victimization: Findings from three Youth Internet Safety Surveys 2000–2010. Journal of Adolescent Health 50, 179–186.

Joshi, S. P., Peter, J., & Valkenburg, P. M. (2011). Scripts of sexual desire and danger in US and Dutch teen girl magazines: A cross-national content analysis. Sex Roles, 64, 463–474.

Kaestle, C. E., Halpern, C. T., & Brown, J. D. (2007). Music videos, pro wrestling, and acceptance of date rape among middle school males and females: An exploratory analysis. Journal of Adolescent Health, 40,


185–187. Kaiser Family Foundation. (2001, June 19). Public and networks getting

comfortable with condom advertising on TV [Press release]. Menlo Park, CA: Author.

Kaiser Family Foundation. (2004). Entertainment education and health in the United States. Menlo Park, CA: Author.

Kaiser Family Foundation. (2006, August 14). FOX Networks Group, Kaiser Family Foundation hit “Pause” [Press release]. Menlo Park, CA: Author.

Kaiser Family Foundation. (2011). Sexual health of adolescents and young adults in the United States. Menlo Park, CA: Author.

Kaiser Family Foundation & Children Now. (1999). Talking with kids about tough issues: A national survey of parents and kids. Menlo Park, CA: Kaiser Family Foundation.

Kalichman, S. C., & Hunter, T. L. (1992). The disclosure of celebrity HIV infection: Its effects on public attitudes. American Journal of Public Health, 82, 1374–1376.

Kann, L., Brener, N., McManus, T., & Wechsler, H. (2012). HIV, other STD, and pregnancy prevention education in public secondary schools—45 states, 2008–2010. Morbidity and Mortality Weekly Report, 61, 222– 228.

Keller, S. N., LaBelle, H., Karimi, N., & Gupta, S. (2002). STD/HIV prevention for teenagers: A look at the Internet universe. Journal of Health Communication, 7, 341–353.

Kelly, C. (2005, October 17). Realities of teen sex ignored in mainstream films. Seattle Times. Retrieved from

Kelly, J., & Smith, S. L. (2006). Where the girls aren’t: Gender disparity saturates G-rated films. Duluth, MN: Dads & Daughters.

Kilbourne, J. (1999). Deadly persuasion: Why women and girls must fight the addictive power of advertising. New York, NY: Free Press.

Kim, J. L., Collins, R. L., Kanouse, D. E., Elliott, M. N., Berry, S. H., Hunter, S., . . . Kunkel, D. (2006). Sexual readiness, household policies, and other predictors of adolescents’ exposure to sexual content in mainstream entertainment television. Media Psychology, 8, 449–471.

Kim, J. L., Sorsoli, C. L., Collins, K., Zylbergold, B. A., Schooler, D., & Tolman, D. L. (2007). From sex to sexuality: Exposing the heterosexual script on primetime network television. Journal of Sex Research, 44,


145–157. Kirby, D., & Laris, B. A. (2009). Effective curriculum-based sex and

STD/HIV programs for adolescents. Child Development Perspectives, 3, 21–29.

Kirby, D., Brener, N. D., Brown, N. L., Peterfreund, N., Hillard, P., & Harrist, R. (1999). The impact of condom distribution in Seattle schools on sexual behavior and condom use. American Journal of Public Health, 89, 182–187.

Kistler, M. E., & Lee, M. J. (2010). Does exposure to sexual hip-hop music videos influence the sexual attitudes of college students? Mass Communication and Society, 13, 67–86.

Klein, J. D., Brown, J. D., Childers, K. W., Oliveri, J., Porter, C., & Dykers, C. (1993). Adolescents’ risky behavior and mass media use. Pediatrics, 92, 24–31.

Kristof, N. (2006, May 2). Beyond chastity belts. New York Times, p. A25. Kubey, R., Banerjee, S. C., & Donovan, B. W. (2012). Media and the

family. In D. G. Singer & J. L. Singer (Eds.), Handbook of children and the media (2nd ed., pp. 341–361). Thousand Oaks, CA: Sage.

Kunkel, D., Cope, K. M., & Biely, E. (1999). Sexual messages on television: Comparing findings from three studies. Journal of Sex Research, 36, 230–236.

Kunkel, D., Cope, K. M., & Colvin, C. (1996). Sexual messages on family hour television: Content and context. Menlo Park, CA: Kaiser Family Foundation.

Kunkel, D., Eyal, K., Finnerty, K., Biely, E., & Donnerstein, E. (2005). Sex on TV 4: A biennial report to the Kaiser Family Foundation. Menlo Park, CA: Kaiser Family Foundation.

Lagus, K. A., Bernat, D. H., Bearinger, L. H., Resnick, M. D., & Eisenberg, M. E. (2011). Parental perspectives on sources of sex information for young people. Journal of Adolescent Health, 49, 87–89.

Lampman, C., Rolfe-Maloney, B., David, E. J., Yan, M., McCermott, N., Winters, S., . . . Lathrop, R. (2002). Messages about sex in the workplace: A content analysis of primetime television. Sexuality and Culture, 6, 3–21.

Leahy, M. (2009). Porn University XXX: What college students are really saying about sex on campus. Chicago, IL: Northfield.

L’Engle, K. L., Brown, J. D., & Kenneavy, K. (2006). The mass media are an important context for adolescents’ sexual behavior. Journal of


Adolescent Health, 38, 186–192. L’Engle, K. L., & Jackson, C. (2008). Socialization influences on early

adolescents’ cognitive susceptibility and transition to sexual intercourse. Journal of Research on Adolescence, 18, 353–378.

Lenhart, A. (2009, December 15). Teens and sexting. Washington, DC: Pew Research Center, Pew Internet & American Life Project, Millennials: A Portrait of Generation Next.

Levin, D. E., & Kilbourne, J. (2009). So sexy so soon: The new sexualized childhood and what parents can do to protect their kids. New York, NY: Ballantine.

Levine, D. (2011, May 10). Pop culture sex ed: What media teaches us about sexual health. Huffington Post. Retrieved from

Levine, D., McCright, J., Dobkin, L., Woodruff, A. J., & Klausner, J. D. (2008). SexInfo: A sexual health text messaging service for San Francisco youth. American Journal of Public Health, 98, 1–3.

Lightfoot, M., Comulada, W. S., & Stover, G. (2007). Computerized HIV preventive intervention for adolescents: Implications of efficacy. American Journal of Public Health, 97, 1027–1030.

Lindberg, L. D., & Maddow-Zimet, I. (2012). Consequences of sex education on teen and young adult sexual behaviors and outcomes. Journal of Adolescent Health. doi:10.1016/j.jadohealth.2011.12.028

Lindberg, L. D., Santelli, J. S., & Singh, S. (2006). Changes in formal sex education: 1995–2002. Journal of Adolescent Health, 38, 182–189.

Lithwick , D. (2009, February 14). Textual misconduct: What to do about teens and their dumb naked photos of themselves. Retrieved from

Lo, D. (2011, March 24). Abercrombie is pushing push-up bikinis for 7- year old girls. Racked. Retrieved from bikinis-for-7year-old-girls.php

Loftus, P. (2011, January 25). Glaxo pulls some ads, citing image. Wall Street Journal. Retrieved from

Lou, C.-H., Zhao, Q., Gao, E.-S., & Shah, I. H. (2006). Can the Internet be used effectively to provide sex education to young people in China? Journal of Adolescent Health, 39, 720–728.


Lounsbury, K., Mitchell, K. J., & Finkelhor, D. (2011). The true prevalence of “sexting.” Retrieved from University of New Hampshire, Crimes Against Children Research Center website:

Luder, M-T., Pittet, I., Berchtold, A., Akre, C., Michaud, P. A., & Suris, J. C. (2011). Associations between online pornography and sexual behavior among adolescents: Myth or reality? Archives of Sexual Behavior, 40, 1027–1035.

Mager, J., & Helgeson, J. G. (2011). Fifty years of advertising images: Some changing perspectives on role portrayals along with enduring consistencies. Sex Roles, 64, 238–252.

Malamuth, N., & Huppin, M. (2005). Pornography and teenagers: The importance of individual differences. Adolescent Medicine Clinics, 16, 315–326.

Manganello, J. A., Henderson, V. R., Jordan, A., Trentacoste, N., Martin, S., Hennessy, M., & Fishbein, M. (2010). Adolescent judgment of sexual content on television: Implications for future content analysis research. Journal of Sex Research, 47, 364–373.

Mann, L. (2012, July 18). Credible online health information eludes collegians. Chicago Tribune. Retrieved from control-advice-20120718_1_emergency-contraception-abortion-pills- plan-b-one-step

Martin, D. (2010, February). MTV drops “Music Television” from the network logo. Los Angeles Times. Retrieved from television-from-its-logo.html

Martinez, G., Abma, J., & Copen, C. (2010). Educating teenagers about sex in the United States (NCHS Data Brief No. 44). Hyattsville, MD: National Center for Health Statistics.

Martinez, G., Copen, C. E., & Abma, J. C. (2011). Teenagers in the United States: Sexual activity, contraceptive use, and childbearing, 2006–2010 National Survey of Family Growth. Vital Health Statistics, 23(21), 1–44.

Martino, S. C., Collins, R. L., Elliott, M. N., Kanouse, D. E., & Berry, S. H. (2009). It’s better on TV: Does television set teenagers up for regret following sexual initiation. Perspectives on Sexual and Reproductive Health, 41, 92–100.

Martino, S. C., Collins, R. L., Elliott, M. N., Strachman, A., Kanouse, D. E.,


& Berry, S. H. (2006). Exposure to degrading versus nondegrading music lyrics and sexual behavior among youth. Pediatrics, 118, e430–e441.

Martino, S. C., Collins, R. L., Kanouse, D. E., Elliott, M., & Berry, S. H. (2005). Social cognitive processes mediating the relationship between exposure to television’s sexual content and adolescents’ sexual behavior. Journal of Personality and Social Psychology, 89, 914–924.

Martino, S. C., Elliott, M. N., Corona, R., Kanouse, D. E., & Schuster, M. A. (2008). Beyond the “big talk”: The roles of breadth and repetition in parent-adolescent communication about sexual topics. Pediatrics, 121, e612–e618.

Mazur, M. A., & Emmers-Sommer, T. M. (2002). The effect of movie portrayals on audience attitudes about nontraditional families and sexual orientation. Journal of Homosexuality, 44, 157–178.

Menard, A. D., & Kleinplatz, P. J. (2008). Twenty-one moves guaranteed to make his thighs go up in flames: Depictions of “great sex” in popular magazines. Sexuality and Culture, 12, 1–20.

Mitchell, K. J., Finkelhor, D., Jones, L. M., & Wolak, J. (2012). Prevalence and characteristics of youth sexting: A national study. Pediatrics, 129, 1– 8.

Monea, E., & Thomas, A. (2011). Unintended pregnancy and taxpayer spending. Perspectives on Sexual and Reproductive Health, 43, 88–93.

Montemurro, B. (2003). Not a laughing matter: Sexual harassment as “material” on workplace-based situation comedies. Sex Roles, 48, 433– 445.

Moreno, M. A., Brockman, L., Rogers, C. B., & Christakis, D. A. (2010). An evaluation of the distribution of sexual references among “top 8” MySpace friends. Journal of Adolescent Health, 47, 418–420.

Moreno, M. A., Brockman, L. N., Wasserheit, J. N., & Christakis, D. A. (2012, January 12). A pilot evaluation of older adolescents’ sexual reference displays on Facebook®. Journal of Sex Research. doi: 10.1080/00224499.2011.642903

Moreno, M. A., & Kolb, J. (2012). Social networking sites and adolescent health. Pediatric Clinics of North America, 59, 601–612.

Moreno, M. A., Parks, M. R., Zimmerman, F. J., Brito, T. E., & Christakis, D. A. (2009). Display of health risk behavior on MySpace by adolescents. Archives of Pediatrics and Adolescent Medicine, 163, 27– 34.

Moreno, M. A., Swanson, M. J., Royer, H., & Roberts, L. J. (2011).


Sexpectations: Male college students’ views about displayed sexual references on females’ social networking Web sites. Journal of Pediatric and Adolescent Gynecology, 24, 85–89.

Moreno, M. A., VanderStoep, A., Parks, M. R., Zimmerman, F. J., Kurth, A., & Christakis, D. A. (2009). Reducing at-risk adolescents’ display of risk behavior on a social networking Web site: A randomized controlled pilot intervention trial. Archives of Pediatrics and Adolescent Medicine, 163, 35–41.

Moreno, M. A., & Whitehill, J. M. (2012). New media, old risks. Archives of Pediatrics and Adolescent Medicine. doi:10.1001/archpediatrics.2012.1320

Morgan, M., Shanahan, J., & Signorielli, N. (2009). Growing up with television: Cultivation processes. In J. Bryant & M. B. Oliver (Eds.), Media effects: Advances in theory and research (3rd ed., pp. 34–49). New York, NY: Routledge.

Mosher, W. D., Chandra, A., & Jones, J. (2005). Sexual behavior and selected health measures: Men and women 15–44 years of age, United States, 2002. Advance Data, 362, 1–55.

Moyer, M. W. (2011, July/August). The sunny side of smut. Scientific American Mind, pp. 14–15.

Mozes, A. (2001, June 19). US TV viewers find condom ads acceptable. Reuters Health. Retrieved from

Mueller, T. E., Gavin, L. E., & Kulkarni, A. (2008). The association between sex education and youth’s engagement in sexual intercourse, age at first intercourse, and birth control use at first sex. Journal of Adolescent Health, 42, 89–96.

Mulvaney, E. (2012, April 5). Teens talk sex via text with new health initiative. Houston Chronicle. Retrieved from new-health-initiative/

Murray, S., & Ouellette, L. (Eds.). (2004). Reality TV: Remaking television culture. New York, NY: New York University Press.

Nabi, R. L., & Clark, S. (2008). Exploring the limit of social cognitive theory: Why negatively reinforced behaviors on TV may be modeled anyway. Journal of Communication, 58, 407–427.

Nabi, R. L., Stitt, C. R., Halford, J., & Finnerty, K. L. (2006). Emotional and cognitive predictors of the enjoyment of reality-based and fictional television programming: An elaboration on the uses and gratifications


perspective. Media Psychology, 8, 421–447. National Campaign to Prevent Teen Pregnancy. (2004). American opinion

on teen pregnancy and related issues 2003. Washington, DC: Author. National Campaign to Prevent Teen and Unplanned Pregnancy. (2008). Sex

and tech. Washington, DC: Author. National Public Radio, Kaiser Family Foundation, & Kennedy School of

Government. (2004). Sex education in America: Principals survey. Menlo Park, CA: Kaiser Family Foundation.

Nauert, R. (2012, April 17). Teen behaviors on Facebook focus of long- term study. PsychCentral. Retrieved from focus-of-long-term-study/37445.html

Navarro, M. (2007, June 10). On abortion, Hollywood is no-choice. New York Times. Retrieved from n=Top/Reference/Times Topics/People/N/Navarro, Mireya&adxnnl=1&adxnnlx=1325088846- LUljr0zFVs69XixNT5yg9w&pagewanted=print

Newman, A. A. (2007, June 18). Pigs with cellphones, but no condoms. New York Times. Retrieved from _r=1&ref=media&oref=slogin

Nielsen Company. (2011a, March 10). State of the media: TV usage trends: Q3 and Q4 2010. Retrieved from trends-q3-and-q4-2010/

Nielsen Company. (2011b, June 8). How the Class of 2011 engages with media. Retrieved from of-2011-engages-with-media/

Nielsen Company. (2012, January 6). State of the media: Consumer usage report 2011. Retrieved from

Nielsen ratings, June 26–July 2. (2006). USA Today. Retrieved from

Noar, S. M., Clark, A., Cole, C., & Lustria, M. L. A. (2006). Review of interactive safer sex Web sites: Practice and potential. Health Communication, 20, 233–241.


O’Hara, R. E., Gibbons, F. X., Gerrard, M., Li, Z., & Sargent J. D. (2012). Greater exposure to sexual content in popular movies predicts earlier sexual debut and increased sexual risk taking. Psychological Science. doi: 10.1177/0956797611435529

O’Sullivan, L. R. (2012). Open to the public: How adolescents blur the boundaries online between the private and public spheres of their lives. Journal of Adolescent Health, 50, 429–430.

One in three boys heavy porn users, study shows. (2007, February 23). ScienceDaily. Retrieved from

Pachal, P. (2011, December 6). New .xxx domain for porn debuts to mixed feelings. USA Today. Retrieved from domain/51680590/1

Pardun, C. (2002). Romancing the script: Identifying the romantic agenda in top-grossing movies. In J. D. Brown, J. R. Steele, & K. Walsh-Childers (Eds.), Sexual teens, sexual media (pp. 211–225). Mahwah, NJ: Lawrence Erlbaum.

Pardun, C. J., & Forde, K. R. (2006). Sexual content of television commercials watched by early adolescents. In T. Reichert & J. Lambiase (Eds.), Sex in promotional culture: The erotic content of media and marketing (pp. 125–139), Mahwah, NJ: Lawrence Earlbaum.

Pardun, C. J., L’Engle, K. L., & Brown, J. D. (2005). Linking exposures to outcomes: Early adolescents’ consumption of sexual content in six media. Mass Communication and Society, 8, 75–91.

Parents Television Council. (2010). Sexualized teen girls: Tinseltown’s new target. Retrieved from

Pazol, K., Zane, S. B., Parker, W. Y., Hall, L. R., Berg, C., & Cook, D. A. (2011). Abortion surveillance—United States, 2008. Morbidity and Mortality Weekly Report, 60(SS15), 1–41.

Pazos, B., Fullwood, E. U., Allan, M. J., Graff, C. A., Wilson, K. M., Laneri, H., & Klein, J. D. (2001, March 22). Media use and sexual behaviors among Monroe County adolescents. Paper presented at the annual meeting of the Society for Adolescent Medicine, San Diego, CA.

Perloff, R. M. (2009). Mass media, social perception, and the third-person effect. In J. Bryant & M. B. Oliver (Eds.), Media effects: Advances in theory and research (pp. 252–268). New York, NY: Routledge.


Perry, R. C., Kayekjian, K. C., Braun, R. A., Sheoran, B., & Chung, P. J. (2012). Adolescents’ perspectives on the use of a text messaging service for preventive sexual health promotion. Journal of Adolescent Health, 51, 220–225.

Peter, J., & Valkenburg, P. M. (2006). Adolescents’ exposure to sexually explicit online material and recreational attitudes toward sex. Journal of Communication, 56, 639–660.

Peter, J., & Valkenburg, P. M. (2008). Adolescents’ exposure to sexually explicit Internet material and sexual preoccupancy: A three-wave panel study. Media Psychology, 11, 207–234.

Peter, J., & Valkenburg, P. M. (2009). Adolescents’ exposure to sexually explicit Internet material and notions of women as sex objects: Assessing causality and underlying processes. Journal of Communication, 59, 407– 433.

Peter, J., & Valkenburg, P. M. (2011). The influence of sexually explicit Internet material and peers on stereotypical beliefs about women’s sexual roles: Similarities and differences between adolescents and adults. Cyberpsychology, Behavior, and Social Networking, 14, 511–517.

Phippen, A. (2009). Sharing personal images and videos among young people. South West Grid for Learning & University of Plymouth, UK. Retrieved from

Piaget, J. (1972). Intellectual evolution from adolescence to adulthood. Human Development, 15, 1–12.

Pinkleton, B. E., Austin, E. W., Cohen, M., Chen, Y.-C., & Fitzgerald, E. (2008). Effects of a peer-led media literacy curriculum on adolescents’ knowledge and attitudes toward sexual behavior and media portrayals of sex. Health Communication, 23, 462–472.

Pinkleton, B. E., Austin, E. W., Chen, Y., & Cohen, M. (2012). The role of media literacy in shaping adolescents’ understanding of and responses to sexual portrayals in mass media. Journal of Health Communication, 17, 460–476.

Pipher, M. (1997, February 1). Bland, beautiful, and boy-crazy. TV Guide, pp. 22–25.

Planned Parenthood Federation of America. (2006). PPFA Maggie Awards: Ripped from the headlines. Retrieved from

Powers, J., & Comstock, G. (2012). The rumors of television’s demise have been greatly exaggerated: What the data say about the future of television


content in a child’s digital world. Mass Communication and Journalism, 2, 111.

Primack, B. A., Douglas, E. L., Fine, M. J., & Dalton, M. A. (2009). Exposure to sexual lyrics and sexual experience among urban adolescents. American Journal of Preventive Medicine, 36, 317–323.

Primack, B. A., Gold, M. A., Schwarz, E. B., & Dalton, M. A. (2008). Degrading and non-degrading sex in popular music: A content analysis. Public Health Reports, 123, 593–600.

Quindlen, A. (2009, March 16). Let’s talk about sex. Newsweek, p. 62. Pujazon-Zazik, M. A., Manasse, S. M., & Orrell-Valente, J. K. (2012).

Adolescents’ self-presentation on a teen dating Web site: A risk-content analysis. Journal of Adolescent Health, 50, 517–520.

Ralph, L. J., Berglas, N. F., Schwartz, S. L., & Brindis, C. D. (2011). Finding teens in TheirSpace: Using social networking sites to connect youth to sexual health services. Sex Research and Social Policy, 8, 38– 49.

Reichelt, P. A. (1978). Changes in sexual behavior among unmarried teenage women utilizing oral contraception. Journal of Population Behavior, 1, 59–68.

Reichert, T., & Carpenter, C. (2004). An update on sex in magazine advertising: 1983 to 2003. Journal of Mass Communication Quarterly, 81, 823–837.

Rice, E., Rhoades, H., Winetrobe, H., Sanchez, M., Montoya, J., Plant, A., & Kordic, T. (2012). Sexually explicit cell phone messaging associated with sexual risk among adolescents. Pediatrics, 130, 667–673.

Rice, L. (2000, April 14). Ready to swear. Entertainment Weekly, pp. 20– 21.

Rich, F. (2004, February 15). My hero, Janet Jackson. New York Times, section 2, p. 1.

Rich, M. (2008). Virtual sexuality: The influence of entertainment media on sexual attitudes and behavior. In J. D. Brown (Ed.), Managing the media monster: The influence of media (from television to text messages) on teen sexual behavior and attitudes. Washington, DC: National Campaign to Prevent Teen and Unplanned Pregnancy.

Rickey, C. (2007, December 7). The absent “a” word. Albuquerque Journal, p. B8.

Rideout, V. (2001). Generation How young people use the Internet for health information. Menlo Park, CA: Kaiser Family


Foundation. Rideout, V. (2007). Parents, children & media. Menlo Park, CA: Kaiser

Family Foundation. Rideout, V. (2008). Television as a health educator: A case study of Grey’s

Anatomy. Menlo Park, CA: Kaiser Family Foundation. Rideout, V. J., Foehr, U. G., & Roberts, D. F. (2010). Generation M2:

Media in the lives of 8- to 18-year-olds. Menlo Park, CA: Kaiser Family Foundation.

Rivadeneyra, R., & Ward, L. M. (2005). From Ally McBeal to Sabado Gigante: Contributions of television viewing to the gender role attitudes of Latino adolescents. Journal of Adolescent Research, 20, 453–475.

Roan, S. (2010, August 29). Get erectile dysfunction ads out of prime time, nations’ pediatricians say. Los Angeles Times. Retrieved from

Roberts, D. F., & Christenson, P. G. (2012). Popular music: The soundtrack of adolescence. In D. G. Singer & J. L. Singer (Eds.), Handbook of children and the media (2nd ed., pp. 479–500). Thousand Oaks, CA: Sage.

Roberts, D., Foehr, U., & Rideout, V. (2005). Generation M: Media in the lives of 8-18 year olds. Menlo Park, CA: Kaiser Family Foundation.

Roberts, E. (1983). Teens, sexuality and sex: Our mixed messages. Television and Children, 6, 9–12.

Romer, D., Sznitman, S., DiClemente, R., Salazar, L. F., Vanable, P. A., Carey, M. P., . . . Juzang, I. (2009). Mass media as an HIV-prevention strategy: using culturally sensitive messages to reduce HIV-associated sexual behavior of at-risk African American youth. American Journal of Public Health, 99, 2150–2159.

Ruff, B. (2009, May 7). Erectile dysfunction ads too hot for TV? Retrieved from ads-too-hot-for-tv/

Ryan, D. (2012, February 13). Teachers urged to address porn factor. Sydney Morning Herald. Retrieved from porn-factor-20120211-1svr0.html

Sabina, C., Wolak, J., & Finkelhor, D. (2008). The nature and dynamics of Internet pornography exposure for youth. CyberPsychology and Behavior, 11, 1–2.

Salamon, J. (2000, December 10). Sex at 8: The Partridges don’t live here


anymore. New York Times, p. 6WK. Santelli, J. (1997). Human subjects protection and parental permission in

adolescent health research. Journal of Adolescent Health, 21, 384–387. Santelli, J., Ott, M. A., Lyon, M., Rogers, J., Summers, D., & Schleifer, R.

(2006). Abstinence and abstinence-only education: A review of U.S. policies and programs. Journal of Adolescent Health, 38, 72–81.

Schuster, M. A., Bell, R. M., Berry, S. H., & Kanouse, D. E. (1998). Impact of a high school condom availability program on sexual attitudes and behaviors. Family Planning Perspectives, 30, 67–72.

Sellers, D. E., McGraw, S. A., & McKinlay, J. B. (1994). Does the promotion and distribution of condoms increase sexual activity? Evidence from an HIV prevention program for Latino youth. American Journal of Public Health, 84, 1952–1959.

Setoodeh, R. (2010, July 26). I want my music videos! Newsweek, pp. 52– 53.

Sexuality Information and Education Council of the United States. (2006, July 19). States and communities push back against abstinence-only- until-marriage dictates from Washington while proliferation of programs continues [Press release]. Retrieved from

Shafer, A., Bobkowski, P., & Brown, J. D. (2013). Sexual media practice: How adolescents select, engage with, and are affected by sexual media (pp. 223–251). In K.E. Dill (Ed.). The Oxford handbook of media psychology. New York: Oxford University Press.

Signorielli, N. (2001). Television’s gender role images and contribution to stereotyping. In D. G. Singer & J. L. Singer (Eds.), Handbook of children and the media (pp. 341–358). Thousand Oaks, CA: Sage.

Singer, N. (2009, February 10). A birth control pill that promised too much. New York Times. Retrieved from

Smith, S., & Choueiti, M. (2010). Gender disparity on screen and behind the camera in family films. Los Angeles, CA: USC Annenberg School for Communications and Journalism.

Smith, S. L., Choueiti, M., Prescott, A., & Pieper, K. (2013). Gender roles & occupations: a look at character attributes and job-related aspirations in film and television. Los Angeles: Geena Davis Foundation.

Sniderman, Z. (2011, August 11). MTV app locates places to get condoms.


Mashable Social Media. Retrieved from

Society for Adolescent Medicine. (2000). Media and contraception [Policy statement]. Journal of Adolescent Health, 27, 290–291.

Stankiewicz, J. M., & Rosselli, F. (2008). Women as sex objects and victims in print advertisements. Sex Roles, 58, 579–589.

Steele, J. R. (1999). Teenage sexuality and media practice: Factoring in the influence of family, friends, and school. Journal of Sex Research, 36, 331–341.

Steele, J. R. (2002). Teens and movies: Something to do, plenty to learn. In J. D. Brown, J. R. Steele, & K. Walsh-Childers (Eds.), Sexual teens, sexual media (pp. 227–251). Mahwah, NJ: Lawrence Erlbaum.

Steinberg, L., & Monahan, K. C. (2011). Adolescents’ exposure to sexy media does not hasten the initiation of sexual intercourse. Developmental Psychology, 47, 562–576.

Stern, B. B., Russell, C. A., & Russell, D. W. (2005). Vulnerable women on screen and at home: Soap opera consumption. Journal of Macromarketing, 25, 222–225.

Strasburger, V. C. (1989). Adolescent sexuality and the media. Pediatric Clinics of North America, 36, 747–774.

Strasburger, V. C. (1995). Adolescents and the media: Medical and psychological impact. Newbury Park, CA: Sage.

Strasburger, V. C. (1998). Parental permission in adolescent health research [Letter]. Journal of Adolescent Health, 22, 362.

Strasburger, V. C. (2006). “Clueless”: Why do pediatricians underestimate the influence of the media on children and adolescents? Pediatrics, 117, 1427–1431.

Strasburger, V. C. (2009). Why do adolescent health researchers ignore the impact of the media? Journal of Adolescent Health, 44, 203–205.

Strasburger, V. C. (2012a). Adolescents, sex, and the media. Adolescent Medicine: State of the Art Reviews, 23, 15–33.

Strasburger, V. C. (2012b). School daze: Why are teachers and schools missing the boat on media? Pediatric Clinics of North America, 59, 705– 716.

Strasburger, V. C., Brown, R. T., Braverman, P. K., Rogers, P. D., Holland- Hall, C., & Coupey, S. M. (2006). Adolescent medicine: A handbook for primary care. Philadelphia, PA: Lippincott Williams & Wilkins.


Strasburger, V. C., & Council on Communications and Media. (2010). Sexuality, contraception, and the media [Policy statement]. Pediatrics, 126, 576–582.

Strasburger, V. C., Jordan, A. B., & Donnerstein, E. (2012). Children, adolescents, and the media: Health effects. Pediatric Clinics of North America, 59, 533–587.

Strassberg, D. S., McKinnon, R. K., Sustaita, M. A., & Rullo, J. (2012). Sexting by high school students: An exploratory and descriptive study. Archives of Sexual Behavior. doi: 10.1007/s10508-012-9969-8

Strauss, G. (2010, January 20). Sex on TV: Increasingly uncut—and unavoidable. USA Today. Retrieved from sexcov20_CV_N.htm

Suellentrop, K., Brown, J., & Ortiz, R. (2010). Evaluating the impact of MTV’s 16 and Pregnant on teen viewers’ attitudes about teen pregnancy. Washington, DC: National Campaign to Prevent Teen and Unplanned Pregnancy.

Svedin, C. G., Akerman, I., & Priebe, G. (2011). Frequent users of pornography: A population based epidemiological study of Swedish male adolescents. Journal of Adolescence, 34, 779–788.

Tannen, T. (2003). Media giant and foundation team up to fight HIV/AIDS. The Lancet, 361, 1440–1441.

Taylor, L. D. (2005a). All for him: Articles about sex in American lad magazines. Sex Roles, 3, 153–163.

Taylor, L. D. (2005b). Effects of visual and verbal sexual television content and perceived realism on attitudes and beliefs. Journal of Sex Research, 42, 130–137.

Taylor, L. D. (2006). College men, their magazines, and sex. Sex Roles, 55, 693–702.

Teens “borrow” babies to practice parenting on reality show. (2007, January 12). ABC News. Retrieved from

Temple, J. R., Paul, J. A., van den Berg, P., Le, V. D., McElhany, A., & Temple, B. W. (2012). Teen sexting and its association with sexual behaviors. Archives of Pediatrics and Adolescent Medicine. doi:10.1001/archpediatrics.2012.835

Ter Bogt, T. F. M., Engels, R. C. M. E., Bogers, S., & Kloosterman, M. (2010). “Shake it baby, shake it”: Media preferences, sexual attitudes and


gender stereotypes among adolescents. Sex Roles, 63, 844–859. Timmerman, L. M., Allen, M., Jorgensen, J., Herrett-Skjellum, J., Kramer,

M. R., & Ryan, D. J. (2008). A review and meta-analysis examining the relationship of music content with sex, race, priming, and attitudes. Communication Quarterly, 56, 303–324.

Tobin, A.-M. (2011, June 16). Internet more useful than parents in sex education, some teens report. Canadian Press. Retrieved from 110617/

Tolman, D. L., Kim, J. L., Schooler, D., & Sorsoli, C. L. (2007). Rethinking the associations between television viewing and adolescent sexuality development: Bringing gender into focus. Journal of Adolescent Health, 40, 84e9–84e16.

Tomashoff, C. (2011, March 6). Are the kids all right? TV Guide, pp. 12– 14.

Tortolero, S. R., Markham, C. M., Peskin, M. F., Shegog, R., Addy, R. C., Escobar-Chaves, S. L., & Baumler, E. R. (2009). It’s Your Game: Keep It Real: Delaying sexual behavior with an effective middle school program. Journal of Adolescent Health, 46, 169–179.

Treise, D., & Gotthoffer, A. (2001). Stuff you couldn’t ask your parents about: Teens talking about using magazines for sex information. In J. D. Brown, J. R. Steele, & K. Walsh-Childers (Eds.), Sexual teens, sexual media (pp. 173–189). Mahwah, NJ: Lawrence Erlbaum.

Trenholm, C., Devaney, B., Forston, K., Quay, L., Wheeler, J., & Clark, M. (2007). Impacts of four Title V, Section 510 abstinence education programs. Princeton, NJ: Mathematica Policy Research.

Tuck, L. (2011, January/February). Viewer discretion advised. Retrieved from

Tucker, K. (1999, December 17). Kids these days. Entertainment Weekly, pp. 62–63.

Tucker, M. E. (2000, April). Teen sex. Pediatric News, p. 5. Turner, J. S. (2011). Sex and the spectacle of music videos: An examination

of the portrayal of race and sexuality in music videos. Sex Roles, 64, 173–191.

United Nations Department of Economic and Social Affairs, Statistics Division. (2011). Demographic yearbook 2008. Retrieved from


University of Montreal. (2011, June 24). Teens look to parents as guide to healthy sexual behaviors [Press release]. Retrieved from look-to-parents-more-than-friends-for-sexual-role-models.html

Van Damme, E., & Van Bauwel, S. (2013, in press). Sex as spectacle: An overview of gender and sexual scripts in teen series popular with Flemish teenagers. Journal of Children and Media.

Wakefield, D. (1987, November 7). Teen sex and TV: How the medium has grown up. TV Guide, pp. 4–6.

Walsh-Childers, K. (1997). A content analysis: Sexual health coverage in women’s, men’s, teen and other specialty magazines. Menlo Park, CA: Kaiser Family Foundation.

Walsh-Childers, K., Gotthoffer, A., & Lepre, C. R. (2002). From “just the facts” to “downright salacious”: Teens’ and women’s magazines’ coverage of sex and sexual health. In J. D. Brown, J. R. Steele, & K. Walsh-Childers (Eds.), Sexual teens, sexual media (pp. 153–171). Mahwah, NJ: Lawrence Erlbaum.

Ward, L. M. (1995). Talking about sex: Common themes about sexuality in the prime-time television programs children and adolescents view most. Journal of Youth and Adolescence, 24, 595–615.

Ward, L. M., & Friedman, K. (2006). Using TV as a guide: Associations between television viewing and adolescents’ sexual attitudes and behavior. Journal of Research on Adolescence, 16, 133–156.

Ward, L. M., Gorbine, B., & Cytron, A. (2002). Would that really happen? Adolescents’ perceptions of sexual relationships according to prime-time television. In J. D. Brown, J. R. Steele, & K. Walsh-Childers (Eds.), Sexual teens, sexual media (pp. 95–123). Mahwah, NJ: Lawrence Erlbaum.

Ward, L. M., Hansbrough, E., & Walker, E. (2005). Contributions of music video exposure to Black adolescents’ gender and sexual schemas. Journal of Adolescent Research, 20, 143–166.

Ward, L. M., Merriwether, A., & Caruthers, A. (2006). Breasts are for men: Media, masculinity ideologies, and men’s beliefs about women’s bodies. Sex Roles, 55, 703–714.

Weinberg, C. (2006). This is not a love story: Using soap opera to fight HIV in Nicaragua. Gender and Development, 14, 37–46.

Weiner, S. (2007, February 20). Goodbye to girlhood. Washington Post, p. HE01.


Williams, A. L., & Merten, M. J. (2008). A review of online social networking profiles by adolescents: Implications for future research and intervention. Adolescence, 43, 253–274.

Williams, M. E. (2011, September 26). Television’s season of the vagina. Salon. Retrieved from

Wilson, C. (2010, August 15). Feds: Online “sextortion” of teens on the rise. Associated Press. Retrieved from security/t/feds-online-sextortion-teens-rise/

Wingood, G. M., DiClemente, R. J., Bernhardt, J. M., Harrington, K., Davies, S. L., Robillard, A., & Hook, E. W. (2003). A prospective study of exposure to rap music videos and African American female adolescents’ health. American Journal of Public Health, 93, 437–439.

Wingood, G. M., DiClemente, R. J., Harrington, K., Davies, S., Hook, E. W., & Oh, M. K. (2001). Exposure to X-rated movies and adolescents’ sexual and contraceptive-related attitudes and behavior. Pediatrics, 107, 1116–1119.

Winston, L. (2010). Good, better, best: school-based STD screening in Washington, DC. Washington, DC: U.S. Department of Health.

Wolak, J., Mitchell, K., & Finkelhor, D. (2007). Unwanted and wanted exposure to online pornography in a national sample of youth Internet users. Pediatrics, 119, 247–257.

Wolfe, T. (2001). Hooking Up. New York: Picador. Quote available at:

Wolk, L. I., & Rosenbaum, R. (1995). The benefits of school-based condom availability: Cross-sectional analysis of a comprehensive high school- based program. Journal of Adolescent Health, 17, 184–188.

Worden, N. (2011, February 14). Online video viewing jumps, bolstering Netflix. Wall Street Journal. Retrieved from

Wray, J., & Steele, J. (2002). Girls in print: Figuring out what it means to be a girl. In J. D. Brown, J. R. Steele, & K. Walsh-Childers (Eds.), Sexual teens, sexual media (pp. 191–208). Mahwah, NJ: Lawrence Erlbaum.

Wretzel, S. R., Visintainer, P. F., & Koenigs, L. M. P. (2011). Condom availability program in an inner city public school: Effect on the rates of gonorrhea and chlamydia infection. Journal of Adolescent Health, 49, 324–326.


Wright, P. J. (2011). Mass media effects on youth sexual behavior: Assessing the claim for causality. Communication Yearbook, 35, 343– 386.

Wright, P. J., Malamuth, N. M., & Donnerstein, E. (2012). Research on sex in the media: What do we know about effects on children and adolescents. In D. G. Singer & J. L. Singer (Eds.), Handbook of children and the media (2nd ed., pp. 273–302). Thousand Oaks, CA: Sage.

Ybarra, M. (2011, August 6). Digital adolescence: Myths and truths about growing up with technology. Paper presented at American Psychological Association meeting, Washington, DC.

Ybarra, M. L., Mitchell, K. J., Hamburger, M., Diener-West, M., & Leaf, P. J. (2011). X-rated material and perpetration of sexually aggressive behavior among children and adolescents: Is there a link? Aggressive Behavior, 37, 1–18.

Zhang, Y., Miller, L. E., & Harrison, K. (2008). The relationship between exposure to sexual music videos and young adults’ sexual attitudes. Journal of Broadcasting and Electronic Media, 52, 368–386.

Zuckerbrod N. (2009, May 20). UK officials post shock video of “teen birth.” Associated Press. Retrieved from officials-post-shock-video-of-r1266117.htm

Zurbriggen, E. L., Collins, R. L., Lamb, S., Roberts, T.-A., Tolman, D. L., Ward, L. M., & Blake, J. (2010). Report of the APA Task Force on the sexualization of girls. Retrieved from

Zurbriggen, E. L., & Morgan, E. M. (2006). Who wants to marry a millionaire? Reality dating television programs, attitudes toward sex, and sexual behaviors. Sex Roles, 54, 1–17.



Drugs and the Media*

A cigarette in the hands of a Hollywood star onscreen is a gun aimed at a 12- or 14-year-old.

—Screenwriter Joe Eszterhas Hollywood Animal (2004)

How about that powerful antidrug commercial paid for by the US government? It aired right between the seventh and eighth Budweiser commercials.

—David Letterman, on the 2002 Super Bowl commercials on CBS’s Late Show (as quoted in “Cheers & Jeers,” 2002)

My 6 year-old daughter turned to me and said, “What’s a 4-hour erection?” How do you explain it?

—Kelly Simmons, Executive Vice President Tierney Communications, Philadelphia as quoted in The New York Times

(Elliott, 2004)

The Marlboro Man emanated in 1954 from the minds of Chicago admen Leo Burnett and John Benson, who were trying to devise a more macho pitch for Philip Morris’ filter-tip cigarette and agreed that the “most masculine figure in America” was the cowboy. In the next 40 years, the smoking cowboy traveled the world (and 2 actors who played him died of lung cancer).

—Walter Nugent Into the West (1999)

*An earlier version of this chapter, by Strasburger, appeared in Singer and Singer, 2012.

hile the “War on Drugs” and “Just Say No” campaigns have been waged since the 1980s, children and teenagers have been exposed to more than $20


W billion worth of cigarette, alcohol, and prescription drug advertising annually, which has worked very effectively to get them to “just say yes” to smoking, drinking, and other drugs (Federal Trade Commission, 2011; Strasburger & Council on Communications and Media, 2010a) (see Figure 6.1). In

addition, content analyses show that television programs, movies, popular music, and certain Internet sites all contain appreciable drug content (Federal Trade Commission, 2011; Strasburger, 2013, in press) (see Figure 6.2). Until recently, many correlational studies had found a significant association between exposure to advertising and exposure to drug content, but no conclusions could be made about a cause-and-effect impact. However, increasing evidence now exists that exposure to drug advertising and scenes of smoking or drinking in movies may be one of the leading causes—if not the leading cause—of early adolescent experimentation with cigarettes and alcohol (Sargent, Tanski, & Stoolmiller, 2012; Sargent, Wills, Stoolmiller, Gibson, & Gibbons, 2006).

Adolescent Drug Use

Figure 6.1


SOURCE: Copyright © Jim Borgman

Figure 6.2a Substance appearance in popular movies and songs. Note that movies far exceed songs as a source of drug depictions.

SOURCE: Christenson, Henriksen, and Roberts (2000).

Figure 6.2b Substance use in television.

SOURCE: Christenson, Henriksen, and Roberts (2000).


Illegal drugs certainly take their toll on society, but tobacco and alcohol— two legal drugs—pose a far greater danger to children and teenagers. Every year, more than 400,000 Americans die from tobacco-related causes—more than from AIDS, car crashes, murder, and suicide combined (Strasburger & Council on Communications and Media, 2010a) (see Figure 6.3). Tobacco is the only known legal drug that kills when used as directed. And each day in the U.S., approximately 4,000 adolescents try their first cigarette (Centers for Disease Control and Prevention [CDC], 2008).

Figure 6.3

SOURCE: ©The New Yorker 2002 Alex Gregory from All rights reserved.

With increased globalization, concerns are emerging about the impact of American tobacco exports on worldwide smoking rates (Prokhorov et al., 2006). More than 1.1 billion people currently smoke worldwide, resulting in 4 million deaths per year. Nearly 100,000 young people begin smoking daily (Tanski, Prokhorov, & Klein, 2004). If this trend continues, a billion people will die prematurely of smoking-related causes during this century (World Health Organization, 2008). Secondhand smoke has also become an


important problem in developing countries. The World Health Organization (WHO) reports that 700 million children are exposed to environmental smoke annually, especially in countries like India, China, Indonesia, Pakistan, and Russia (Prokhorov et al., 2006). The U.S. is the leading producer of cigarettes, exporting three times as many as any other country, and American tobacco companies are increasingly turning overseas as the U.S. market tightens (Womach, 2003). While most of the dangers of smoking and of secondhand smoke are well understood (lung cancer, other cancers, heart disease, respiratory illness, infertility, etc.), new research is finding additional concerns for young people (U.S. Department of Health and Human Services, 2012). Smoking may cause damage to lung cell DNA, producing physiological changes that persist despite quitting smoking (Wiencke et al., 1999). Tobacco use may also be a marker for depression and anxiety disorders in adolescence (Sims & Committee on Substance Abuse, 2009).

Alcohol is the most commonly abused drug by young people ages 12 to 17 years (Committee on Substance Abuse, 2010) and may account for as many as 100,000 deaths annually, including 5,000 people under 21 years (U.S. Department of Health and Human Services, 2007; Williams & Ribisl, 2012). In the U.S. alone, alcohol accounts for 28,000 unintentional injury deaths, 17,000 traffic deaths, 300,000 traffic injuries, and 1.4 million injury visits to the emergency department annually (Hingson & Zha, 2009). In a large study of more than 44,000 fatally injured drivers between 1998 and 2009, 37% exceeded the legal limit for alcohol (Romano & Voas, 2011). The risk of an injury increases ninefold among patients who have consumed five to six drinks in the past few hours (Hingson & Zha, 2009). In the most recent survey of teen highway deaths, 20% of the 1,280 sixteen- to nineteen- year-old drivers had alcohol in their system. One in 10 students reports having driven after drinking during the past 30 days, and most students who drive after drinking have been binge drinking (CDC, 2012a; CDC, 2013).

In fact, underage drinkers account for about 20% of all alcohol consumption (Foster, Vaughan, Foster, & Califano, 2003) and for one-third of all alcohol industry revenues (Foster, Vaughan, Foster, & Califano, 2006). Underage drinking costs society an estimated $68 billion a year, however (National Center on Addiction and Substance Abuse, 2011a). Physicians who treat teenagers know that alcohol can contribute significantly to the three leading causes of death among teens—accidents, homicides, and suicides—which together account for 75% of their mortality rate (J.W. Kulig & Committee on Substance Abuse, 2005; Swahn, Bossarte,


& Sullivent, 2008; Thompson, Sims, Kingree, & Windle, 2008). Research is increasingly discovering that alcoholism begins young; nearly half of all alcoholics are diagnosable before age 21(S.A. Brown et al., 2008; Hingson, Heeren, & Winter, 2006). Globally, alcohol consumption causes 1.8 million deaths (3.2%) annually and is the leading risk factor for morbidity in many developing countries (WHO, 2007).

Nine out of 10 Americans who meet the medical criteria for addiction started smoking, drinking, or using other drugs before the age of 18. In a cross-sectional study of more than ten thousand 13- to 18-year-olds, the median age at onset for alcohol and drug abuse was 14 to 15 years (Swendsen et al., 2012). Total costs of substance use for federal, state, and local governments are estimated to be at least $468 billion per year (National Center on Addiction and Substance Abuse, 2011a). The best data regarding adolescent drug use come from the University of Michigan’s Monitoring the Future study (MTF), which surveys nearly 45,000 students annually in the 8th, 10th, and 12th grades at more than 430 public and private schools across the country ( Funded by the National Institute on Drug Abuse (NIDA), this study has been conducted annually since the mid-1970s (see Figure 6.4 and Tables 6.1 and 6.2). No data set is perfect, however. The MTF fails to capture high school dropouts—who may have very high rates of drug use—and depends on self- reporting by teens. But no other collection of data is so extensive over so long a period of time. The next best source of data is the Youth Risk Behavior Survey (YRBS), conducted by the CDC every two years in nearly every state ( (see Figures 6.5 and 6.6). The 2009 survey included more than 13,000 students in 8th grade and more than 15,000 in 10th and 12th grades.

Figure 6.4 Trends in annual prevalence of 12th graders’ use of illegal drugs, 1975–2011.


SOURCE: Data from the Monitoring the Future study, University of Michigan. Reprinted with permission.

Table 6.1 Adolescent Drug Use, 2012 (in percentages) (N =13,700 Grade 12 students)


SOURCE: Adapted from Johnston, O’Malley, Bachman, and Schulenberg (2013).

Table 6.2 Trends in 12th Graders’ Perception of Drugs as Harmful (in percentages)


SOURCE: Adapted from Johnston, O’Malley, Bachman, and Schulenberg (2013).

Highlights of the 2011 MTF survey and the 2011 YRBS include the following (CDC, 2012b; Johnston et al., 2013; CDC, 2013):

• There have been continued decreases in smoking levels, which according to the MTF reached a peak in 1996 and 1997. Whereas in 1996, 49% of 8th graders had tried cigarettes at some point in their lives, in 2011, only 18% had. Those reporting cigarette use in the month prior to being surveyed had decreased from 21% of 8th graders in 1996 to 6% in 2011, from 30% of 10th graders in 1996 to 12% in 2011, and from 37% of 12th graders in 1996 to 19% in 2011. Interestingly, in 2011, more than 80% of 8th and 10th graders and 75% of 12th graders said they “would prefer to date people who don’t smoke.”

• At the same time, the YRBS found that nearly half of all teenagers had tried smoking cigarettes at some time, down from a high of 71% in 1995 but still an alarming figure. More than 10% had smoked a cigarette before age 13.

Figure 6.5 Trends in lifetime cigarette use among high school students.


SOURCE: National Center on Addiction and Substance Abuse at Columbia University (2011a).

• A leveling off in alcohol use rates has occurred. Nearly three-fourths of 12th graders have tried alcohol at least once, down from a peak of 88% in 1991. One-third of 8th graders have tried alcohol at least once. More worrisome are the figures for binge drinking and having ever being drunk. While only 6% percent of 8th graders reported having consumed five or more drinks of alcohol in the two weeks prior to being surveyed, 15% of 10th graders and nearly one-fourth of all high school seniors have engaged in binge drinking. About 17% of 8th graders, 36% of 10th graders, and half of 12th graders reported having been drunk at some point in their lives.

Figure 6.6 Trends in alcohol use among high school students.


SOURCE: National Center on Addiction and Substance Abuse at Columbia University (2011a).

In the YRBS, 39% of high school students reported having had at least one drink of alcohol in the 30 days prior to being surveyed, and 22% reported binge drinking during the previous 30 days. Although athletes are ordinarily less likely to use illicit drugs other than anabolic steroids (K. Kulig, Brener, & McManus, 2003), male athletes may be more likely to use alcohol (Fisher, Miles, Austin, Camargo, & Colditz, 2007).

• Levels of illicit drug use among teenagers have remained relatively stable over the past several years. Use peaked at 66% in 1981 and declined to a low of 41% in 1992. Currently, nearly half of all seniors, more than a third of sophomores, and one in five 8th graders report having used an illicit drug. One-fourth of seniors have used an illicit drug other than marijuana.

• A leveling off in marijuana use among teenagers has occurred. Marijuana use peaked in 1979, when 60% of high school seniors reported having tried it. Now, just over 45% of seniors say that they have tried marijuana.

• Marijuana, cocaine, heroin, and MDMA (“ecstasy”) use bottomed out in the early 1990s, began rising in the mid to late 1990s, and now has slowly decreased again.

• For all drugs, it is important to understand that young adults and older adults have higher rates of smoking and alcohol use, and young adults have the highest rates of illicit drug use. But the onset of alcohol and


tobacco use invariably occurs during adolescence.

The United States is not unique in having an adolescent drug problem. More than half of all female 15-year-olds in Greenland smoke daily, 85% of Scottish 11-year-olds have tried alcohol at least once, more than half of Welsh 15-year-olds consume alcohol at least weekly, and more than 70% of Danish 15-year-olds have been drunk at least twice (Currie, Hurrelmann, Settertobulte, Smith, & Todd, 2000). In the United Kingdom, 10% to 12% of 15-year-olds reported having used marijuana in the month prior to being surveyed (Brooks et al., 2009).

Determinants of Child and Adolescent Drug Use Adolescent drug use is associated with a number of different factors, including poor self-image, low religiosity, poor school performance, alienation from parents, family dysfunction, physical and emotional abuse, and self-medication (Briones, Wilcox, Mateus, & Boudjenah, 2006; Fisher et al., 2007; Schydlower & Arredondo, 2006; Shrier, Harris, Kurland, & Knight, 2003). Media can play an important role as well, making substance use, especially smoking and drinking, seem like “normative” behavior. Reviews of adolescent substance use often fail to mention media influence as an etiologic agent for young people initiating drug use (Strasburger, 1998), and researchers typically neglect to ask media-related questions when they survey teens for substance use (Strasburger, 2009b).

Peers Peer pressure may play one of the most important roles in early drug use

among young teens (Bahr, Hoffmann, & Yang, 2005), but it may also be a key factor in teens abstaining from drugs as well. Teens who see their friends using drugs are more likely to do so themselves; teens who believe their friends are anti-drugs are more likely to abstain (Robin & Johnson, 1996). (Another possible and as-yet untested hypothesis is that teens prone to drug use or to abstaining search out like-minded peers.) Mapping the social networks of nearly 8,500 adolescents has shown that the likelihood of marijuana use may increase if “friends” are known to use drugs (Mednick, Christakis, & Fowler, 2010).


In many ways, the media can function as a “super-peer,” making it seem as if “everyone” is using alcohol, tobacco, or other drugs (Strasburger, 1995). Because teens always want to be doing what is “normal” and “current” for their peer group (Olds, Thombs, & Tomasek, 2005), the media may represent one of the most powerful influences on their behavior. Media are also a leading source of health information for teens. One study of nearly 800 students in 5th to 12th grade found that television was the leading source of information about smoking (Kurtz, Kurtz, Johnson, & Cooper, 2001).

Family Parents represent an important influence on whether teens use drugs or

not. Depending on the circumstances, parents can be a significant risk factor or a significant protective factor (Bahr et al., 2005; Briones et al., 2006; Halpern-Felsher & Cornell, 2005). Abused children are at greater risk for drug use, for example. Similarly, a “coercive” parenting style can lead to greater substance use and even delinquency (McMahon, 1994). Genetically, alcoholic parents are two to nine times more likely to produce biological children who are alcoholic (Belcher & Shinitzky, 1998). This inherited risk may extend to other drug abuse as well (Comings, 1997). Alternatively, nurturing parents with good communication skills represent a major protective factor (Fisher et al., 2007). Interestingly enough, in a recent poll of parents of 13- to 17-year-olds, only 10% of the parents thought their teens had taken a drink in the past year, and only 5% thought their teens had used marijuana (Keeping, 2011).

Media have sometimes been called “electronic parents,” and if parents and schools fail to give children appropriate information about drugs, the media may fill the void with unhealthy information or cues. For example, latchkey children are more prone to substance use, perhaps because they are unsupervised and have unrestrained access to a variety of potentially unhealthy media (Chilcoat & Anthony, 1996). Likewise, teens who have TV sets in their own bedrooms are more likely to watch more TV and to engage in risky behaviors like sex or using tobacco, marijuana, or alcohol (Gruber, Wang, Christensen, Grube, & Fisher, 2005).

Personality Adolescents are notorious for being risk takers. Part of the explanation


for this comes from new research on brain development that shows that the key areas of the frontal cortex (involved in judgment) do not mature until the early to mid 20s (Giedd, 2008; Walsh & Bennett, 2005). MRI studies of teens with alcohol problems show that areas of the brain involved in drug craving and reward (e.g., the limbic system) light up more in subjects who are being shown pictures of alcoholic beverages than they do in controls (Tapert et al., 2003). Areas of the brain involved in motivating behavior are also different in teenagers (Bjork et al., 2004; White & Swartzwelder, 2004). Both tobacco and alcohol can be considered “gateway drugs” as well, meaning that their use may lead to use of more worrisome drugs later. For example, teens who smoke are 3 times more likely to use alcohol than nonsmokers, 8 times more likely to use marijuana, and 22 times more likely to use cocaine (U.S. Department of Health and Human Services, 2004). Alcohol is often the first drug to be experimented with and may lead to lower grades and risk taking behaviors like premature sexual intercourse and experimentation with other drugs (S.A. Brown et al., 2008; Champion et al., 2004; Rehm, Shield, Joharchi, & Shuper, 2012).

Biology Adolescents’ developing brains may make them more susceptible to

nicotine addiction and require fewer cigarettes smoked to establish addiction compared to adults (Prokhorov et al., 2006). New research shows that the nicotine in cigarettes can become addictive after only a few puffs (Sims & Committee on Substance Abuse, 2009). A small number of adolescents with psychiatric disorders may also use substances like marijuana or alcohol to try to regulate their mood disorders (“Teen ‘Self Medication,’” 2008).

The Impact of Advertising on Children and Adolescents Tobacco and alcohol represent two hugely profitable industries that require the constant recruitment of new users. With the death of 1,200 smokers a day and with thousands more trying to quit, the tobacco industry must recruit new smokers to remain profitable. Inevitably, these new smokers come from the ranks of children and adolescents, especially given the demographics of smoking (50% of smokers begin by age 13, and 80% before age 18 [CDC,


2010; Strasburger & Council on Communications and Media, 2010a]). Worldwide, this amounts to nearly 100,000 young people starting smoking daily (Strasburger & Council on Communications and Media, 2010a). Big Tobacco has engaged in a systematic campaign to attract underage smokers for decades and then lied to Congress about it (Glantz, Slade, Bero, & Hanauer, 1998; Kessler, 2001). Specific age and ethnic groups are often targeted. For example, the Camel No. 9 advertising campaign in 2007 seemed custom made to attract young teenage girls and was very effective (Pierce et al., 2010) (see Figure 6.7). The industry continues to resist any congressional attempts to regulate it (Cruz & Deyton, 2010; “Tobacco Giants Suing,” 2011).

Similarly, the alcohol industry has targeted minority groups and the young for years, particularly through promotion of sports, youth-oriented programming, and flavored alcohol drinks. Because 5% of drinkers consume 40% of all alcoholic beverages, and 20% account for 90% of all alcohol consumption (Greenfield & Rogers, 1999), new recruits— preferably heavy drinkers—are a must for the alcohol industry as well. For underage drinkers, more than 90% of the alcohol drunk is consumed as binge drinking (Jernigan, 2006). A recent study of 11 U.S. magazines with disproportionately adolescent readerships found more than 2,600 alcohol ads between 2003 and 2007, with one-quarter featuring risk, sexual activity, or sexism (Rhoades & Jernigan, 2013).

Figure 6.7 Ad from the 2007 Camel No. 9 campaign.


Celebrity endorsers are commonly used, and older children and teenagers may be particularly vulnerable to such ads (Committee on Communications, 2006; Gunter, Oates, & Blades, 2004). Many commercials for alcohol and ads for tobacco employ some combination of rock music, young attractive models, humor, or adventure (see Figure 6.8). “Beach babes,” frogs, lizards, and dogs are all commonly seen in beer commercials. Sex and humor are particularly effective with adolescents (Salkin, 2007). Production values are extraordinary: Costs for a single 30-second commercial may easily exceed those for an entire half-hour of regular programming, and 30 seconds’ worth of advertising during the 2012 Super Bowl cost $3.5 million (“Their Super Bowl Ads,” 2012). In 2007, Anheuser-Busch bought five entire minutes of advertising during the Super Bowl (Sutel, 2007). Several years ago, a new form of alcoholic beverage was marketed—“hard” lemonades, containing 5% alcohol. These have been dubbed “learner drinks for kids.” They, too, use fictitious cool guys such as “Doc” Otis and One- Eyed Jack and “make a mockery of the industry’s claim that it doesn’t market to kids,” according to one expert (Cowley & Underwood, 2001).


Similarly, until they were banned in 2009, flavored cigarettes were marketed with names like “Beach Breezer,” “Kuai Kolada,” “Twista Lime,” and “Mandarin Mints,” despite the 1998 Master Settlement Agreement (see Table 6.3) that included a promise not to market to children (Harris, 2005).

A variety of studies have explored the impact of advertising on children and adolescents. Nearly all have shown advertising to be extremely effective in increasing youngsters’ awareness of and emotional responses to alcohol products, their recognition of certain brands, their desire to own or use the products advertised, and their recognition of the advertisements themselves (Borzekowski & Strasburger, 2008). There are, however, some researchers who disagree and feel that children have become increasingly sophisticated about the intent of advertising in general and therefore more media resistant to alcohol advertising specifically. They cite the fact that older meta-analyses find a much larger effect size than more recent ones (Desmond & Carveth, 2007). Nevertheless, two recent studies confirm an association: One analysis involved seven prospective cohort studies involving 13,255 subjects and found at least modest effects (Smith & Foxcroft, 2009); a second analysis examined 13 longitudinal studies involving more than 38,000 young people and concluded that “alcohol advertising and promotion increases the likelihood that adolescents will start to use alcohol, and to drink more if they are already using alcohol” (P. Anderson, de Bruijn, Angus, Gordon, & Hastings, 2009, p. 229).

Although the research is not yet considered to be scientifically “beyond a reasonable doubt,” there is a preponderance of evidence that cigarette and alcohol advertising is a significant factor in adolescents’ use of these two drugs (Borzekowski & Strasburger, 2008; Federal Trade Commission, 1999; Grube & Waiters, 2005; Jernigan, 2006; Snyder, Milici, Slater, Sun, & Strizhakova, 2006; U.S. Department of Health and Human Services, 2012). The Federal Trade Commission (1999) report on the alcohol industry concluded, “While many factors may influence an underage person’s drinking decisions, including among other things parents, peers and the media, there is reason to believe that advertising also plays a role.” For alcohol, advertising may account for as much as 10% to 30% of the variance in adolescents’ usage (Atkin, 1995). Interestingly, one study of students’ use of cigarette promotional items found that a similar figure applies to cigarettes as well: Approximately one-third of adolescents’ cigarette use could be predicted by their purchase or ownership of tobacco promotional gear (Pierce, Choi, Gilpin, Farkas, & Berry, 1998). Nevertheless, as one group of researchers notes,


Table 6.3 Some Features of the 1998 Tobacco Master Settlement Agreement

SOURCE: Adapted from AAP News, 15(1): 4 January 1999.

Figure 6.8 Many commercials for alcohol and ads for tobacco employ attractive models, humor, and the promise of adventure.


To reduce the argument regarding the demonstrable effects of massive advertising campaigns to the level of individual behavior is absurdly simplistic….Rather, what we are dealing with is the nature of advertising itself. Pepsi Cola, for example, could not convincingly prove, through any sort of defensible scientific study, that particular children or adolescents who consume their products do so because of exposure to any or all of their ads. (Orlandi, Lieberman, & Schinke, 1989, p. 90)


Although there is some legitimate debate about how much of an impact such advertising has on young people and their decisions regarding whether to use cigarettes or alcohol, advertising clearly works—or else companies would not spend millions of dollars a year on it (the U.S. spends $250 billion a year on advertising, more than any other country in the world by a factor of two). This leaves American society with a genuine moral, economic, and public health dilemma: Should advertising of unhealthy products be allowed, when society then has to pay for the disease, disability, and death that these products cause (Kunkel, 2007; Strasburger, 2012; 2013). Tobacco companies and beer manufacturers claim that they are simply influencing “brand choice,” not increasing overall demand for their products. Moreover, they claim that because it is legal to sell their products, it should be legal to advertise them as well, and any ban represents an infringement on their First Amendment rights of commercial free speech. Recently, a conservative U.S. Supreme Court has seemed to agree with them (Bayer & Kelly, 2010; Gostin, 2009).

Public health advocates counter that tobacco companies and beer manufacturers are engaging in unfair and deceptive practices by specifically targeting young people, using attractive role models and youth-oriented messages in their ads, and making smoking and drinking seem like normative behavior (Borzekowski & Strasburger, 2008; A. Brown & Moodie, 2009; Grube & Waiters, 2005; U.S. Department of Health and Human Services, 1994). Teens are exposed to 48% more beer advertising, 20% more advertising for hard liquor, and 92% more ads for sweet alcoholic drinks in magazines than are adults of legal drinking age (Center on Alcohol Marketing and Youth, 2007; Garfield, Chung, & Rathouz, 2003). Teen girls are actually more likely to be exposed to alcohol advertising than women in their 20s or 30s (Jernigan, Ostroff, Ross, & O’Hara, 2004). The fact that alcohol and tobacco manufacturers are trying to get adolescents to “just say yes” to cigarettes and beer at a time when society is trying to get them to “just say no” to drugs seems like a situation straight out of Alice in Wonderland (Strasburger, 2010). As we shall see, the available data strongly support the public health viewpoint.


The Impact of Cigarette Advertising


More money is spent on the advertising and promotion of tobacco—more than $15 billion in 2003 alone (see Figure 6.9)—than on alcohol ($5 billion/year) or prescription drugs ($4 billion/year) (Federal Trade Commission, 2011; Strasburger & Council on Communications and Media, 2010a).

Most youth in the U.S. are exposed to pro-tobacco messages in the media (see Figure 6.10). In a sample of as many as 33,000 students in 6th to 12th grade, 85% had seen tobacco ads in stores and half had seen ads in newspapers and magazines (Duke et al., 2009).

Figure 6.9 Tobacco company advertising and promotional spending, 1998–2008 (in billions).

SOURCE: Federal Trade Commission (2011).

Figure 6.10 Most youth in the U.S. are exposed to pro-tobacco messages in the media.


NOTE: Joe Camel was outlawed by the 1998 Master Settlement Agreement but is alive and well in other parts of the world (e.g., Argentina, Spain, China, Japan).

Cigarette advertising appears to increase teenagers’ risk of beginning to smoke by glamorizing both the act of smoking and smokers themselves (Borzekowski & Strasburger, 2008; Davis, Gilpin, Loken, Viswanath, & Wakefield, 2008). Attractive celebrities have seemingly always smoked (see Figure 6.11), and smokers are portrayed as being independent, healthy, youthful, unconventional, and adventurous. By contrast, the adverse consequences of smoking are almost never shown. Nearly 20 years ago, the U.S. Surgeon General concluded,

Cigarette advertising appears to affect young people’s perceptions of the pervasiveness, image, and function of smoking. Since misperceptions in these areas constitute psychosocial risk factors for the initiation of smoking, cigarette advertising appears to increase young people’s risk of smoking [emphasis added]. (U.S. Department of Health & Human Services, 1994, p. 195)

The history of cigarette advertising on TV is one of the more remarkable public health stories on record. In June 1967, the Federal Communications Commission (FCC) ruled that the “fairness doctrine” applied to cigarette advertisements, which were being broadcast for 5 to 10 minutes per day. That meant that TV stations would be required to air antismoking ads for free, to provide a “balance” to the pro-tobacco “viewpoint” expressed by


the cigarette ads. The FCC’s decision was subsequently upheld by the courts. The industry volunteered to remove their ads from TV and radio, but Congress refused to permit tobacco companies to discuss it among themselves, claiming it would be a violation of antitrust law. Gradually, as the number of antismoking ads rose, the industry decided it was wise not to oppose the Public Health Cigarette Smoking Act of 1970, which then banned tobacco ads altogether. The upshot of supporting the legislation was that antismoking public service announcements (PSAs) then had to compete with all other PSAs and quickly—dramatically—diminished in quantity. In addition, the tobacco industry used the money saved on TV and radio ads for other forms of marketing and promotion (Fritschler & Hoefler, 2006; K. Warner, personal communication, 2010).

Figure 6.11 Celebrities—and even doctors and babies—have been used to advertise cigarettes.

To this day, some of the industry’s advertising strategies are nearly Orwellian in their sophistication. Litigation originally brought by the U.S. attorneys general uncovered the fact that tobacco companies have specifically targeted teenage smokers as young as age 13 in an attempt to


regain market share (Weinstein, 1998), and a federal judge ruled in 2006 that the tobacco industry had been deceiving the public for five decades about the risks of smoking (“Big Tobacco’s Promises,” 2006). In November 2003, the tobacco industry did agree to cease advertising in school library editions of four magazines with a large youth readership (Time, People, Sports Illustrated, and Newsweek) (“Tobacco Ads,” 2005)”, but the industry continued for a while to target youth with ads in adult magazines with a high youth readership (Alpert, Koh, & Connolly, 2008). Recently, the two largest tobacco companies stopped advertising major brands in many magazines—Philip Morris (e.g., Marlboro) in 2005 and R.J. Reynolds (e.g., Camel) in 2008 (Newman, 2009). At the same time, the industry has begun publishing lifestyle magazines like Unlimited and CML, both of which feature “under-the-radar” strategies like attractive brand imagery that targets young adults (Cortese, Lewis, & Ling, 2009). New marketing strategies also include targeting teen girls and young women with new brands and packages —for example, Camel No. 9 that comes in shiny black boxes with hot pink and teal borders and is advertised with wording like “Light and luscious” or “Now available in stiletto” in women’s magazines like Vogue, Glamour, and Cosmopolitan (Campaign for Tobacco-Free Kids, 2009a; Pierce et al., 2010). Researchers estimate that the Camel No. 9 campaign may have attracted as many as 170,000 new female teenage smokers in just a few years (Pierce et al., 2010). The few studies that have been published that do not find an association between tobacco marketing and teen use have been secretly underwritten by the industry itself (DiFranza et al., 2006). More recently, the industry has attempted to deflect criticism by introducing “youth smoking education and prevention” programs worldwide. The programs stress that smoking is an “adult choice,” that children begin smoking because of peer pressure and lack of guidance from their parents, and that buying cigarettes is illegal for teens. The programs do not mention the fact that nicotine is addictive, that smoking causes disease, or that marketing increases smoking. In addition, the research done for such programs allows the tobacco industry to collect valuable demographic data on teenagers and their habits (Landman, Ling, & Glantz, 2002). Finally, Lewis Carroll might have admired the fact that in 2009 R. J. Reynolds acquired Niconovum, a Swedish company that makes nicotine gum and other nicotine replacement devices to wean smokers off of cigarettes (Gomstyn, 2009).

Perhaps as a result, one in five 8th graders believes that the harmful effects of cigarettes have been exaggerated (Johnston et al., 2012). Tobacco


advertising may even undermine the impact of strong parenting practices (Pierce, Distefan, Jackson, White, & Gilpin, 2002).

In 2008, the magazine landscape changed. Yet ads for smokeless tobacco in magazines with a large youth readership have actually increased (Morrison, Krugman, & Park, 2008). Magazine advertising currently represents only about 1% of the almost $13 billion spent annually on marketing and promotion (Alpert et al., 2008). The major companies could decide to resume print advertising at any time, of course, depending on their business needs (Alpert et al., 2008), but the Family Smoking Prevention and Tobacco Control Act promoted by the Food and Drug Administration (FDA), passed in 2009, will put a crimp in future promotional efforts (Wilson, 2009) (see Table 6.4).

Beginning in the early 1990s, some classic research has more clearly delineated the impact of cigarette advertising on young people. In 1991, two studies examined the impact of the Old Joe the Camel advertising campaign. In one, 6-year-olds were as likely to recognize Old Joe as they were the famous Mouseketeer logo for the Disney Channel (Fischer, Schwartz, Richards, Goldstein, & Rojas, 1991). Even at age 3, 30% of children could make the association between the Old Joe Camel figure and a pack of cigarettes. In the second study, more than twice as many children as adults reported exposure to Old Joe. Not only were children able to recognize the association with Camel cigarettes, but they found the ads to be appealing as well (DiFranza et al., 1991). Not coincidentally, in the three years after the introduction of the Old Joe campaign, the preference for Camel cigarettes increased from 0.5% of adolescent smokers to 32%. During the same time period, the sale of Camels to minors increased from $6 million to $476 million, representing one-quarter of all Camel sales and one-third of all illegal cigarette sales to minors (DiFranza et al., 1991).

Since then, the research has been clear and convincing that tobacco marketing and promotion are highly effective in influencing young people to begin smoking. There are at least four dozen cross-sectional and longitudinal studies (see Table 6.5). The size of the effect remains a matter of discussion (see Table 6.5), although the Hill criteria for causality have been fulfilled (see Hill, 1965) (see Table 6.6).

Table 6.4 Some Provisions of the Tobacco Control Act


SOURCE: American Academy of Pediatrics, Office of Government Affairs, Washington, DC, 2010.

Table 6.5 How Good Is the Research Linking Tobacco Marketing to Onset of Adolescent Smoking?

SOURCE: Adapted from DiFranza and colleagues (2006).

Table 6.6 Does the Research on Tobacco Marketing and Onset of Smoking Fulfill the Hill Criteriaa for Causality?


SOURCE: Adapted from DiFranza and colleagues (2006).

aHill (1965).

Some of the most notable and recent research studies include the following:

Figure 6.12 Crude association between exposure to advertisements and youth smoking.

SOURCE: Hanewinkel, Isensee, Sargent, and Morgenstern (2010). Reprinted with permission.

• Numerous studies that show that children who pay closer attention to cigarette advertisements, who are able to recall such ads more readily, or who own promotional items are more likely to view smoking favorably and to become smokers themselves (Biener &


Siegel, 2000; Hanewinkel, Isensee, Sargent, & Morgenstern, 2010, 2011; Sargent, Dalton, & Beach, 2000; Sargent, Gibson, & Heatherton, 2009) (see Figure 6.12). Teens who smoke are also more likely to believe messages in print ads for cigarettes (Hawkins & Hane, 2000). Among teenage girls, smoking rates increased dramatically around 1967, exactly the same time that women were being targeted by such new brands as Virginia Slims (Pierce, Lee, & Gilpin, 1994).

• Comprehensive three- and six-year longitudinal studies of 1,752 California adolescents who had never smoked that found that one- third of all smoking experimentation in California between 1993 and 1996 could be attributed to tobacco advertising and promotions (Gilpin, White, Messer, & Pierce, 2007; Pierce et al., 1998). These were the first studies to use longitudinal correlational data that could yield cause-and-effect conclusions. More recently, a longitudinal survey of 2,102 ten- to seventeen-year-olds found that high exposure to cigarette ads was a significant predictor of adolescent smoking initiation, even after controlling for many other, known contributing factors (Hanewinkel et al., 2011). At last count, there were 19 longitudinal studies, which consistently show that exposure to tobacco advertising and promotions increases the likelihood of adolescents’ starting to smoke (Lovato, Watts, & Stead, 2011).

• Studies of adolescent brand preferences showing that they closely follow the amount of money that tobacco companies spend on advertising. Marlboro, Newport, and Camel are the brands of choice for 87% of high school smokers (CDC, 2009) (see Table 6.7). Similarly, in England, the most popular brands of cigarettes (Benson & Hedges, Silk Cut, Embassy, and Marlboro) are the mostly heavily advertised (Vickers, 1992).

• A study by Sargent and his colleagues (2000) that found a dose- response relationship between the number of cigarette promotional items owned by adolescents and their smoking behavior.

• A meta-analysis of 51 separate studies that found that exposure to tobacco marketing and advertising more than doubles the risk of a teenager’s beginning to smoke (Wellman, Sugarman, DiFranza, & Winickoff, 2006).

Table 6.7 Is Cigarette Advertising Effective?


SOURCE: Data from Davis, Gilpin, Loken, Viswanath, and Wakefield (2008) and Centers for Disease Control and Prevention (2009). Data for advertising dollars are from 1993 to 2000; data for brand preference are from 2004 and 2006.

aAmong African Americans, Newport is the brand of choice for 79%.

This is hardly an American phenomenon, however. In the United Kingdom, a survey of 1,450 students ages 11 and 12 years found that awareness of cigarette advertising correlated with smoking (While, Kelly, Huang, & Charlton, 1996), as did a survey of nearly 2,000 students who had been exposed to so-called passive cigarette advertising during an India– New Zealand cricket series televised in India. The message conveyed was “You become a better cricketer if you smoke,” and the risk for initiation of smoking in nonsmoking youth tripled if they believed this message (Vaidya, Vaidya, & Naik, 1999). In Germany, a recent cross-sectional survey of 3,415 schoolchildren ages 10 to 17 years also found a two- to threefold higher risk of new-onset smoking with exposure to cigarette ads, as well as a dose-response relationship (Hanewinkel et al., 2010).

Unlike the United States, other countries have been more aggressive in banning cigarette advertising. In New Zealand, consumption fell after a complete ban on cigarette advertising (Vickers, 1992). In Norway, the prevalence of 13- to 15-year-old smokers decreased from 17% in 1975 to 10% in 1990 after an advertising ban was imposed (Vickers, 1992). In fact, an analysis of factors influencing tobacco consumption in 22 countries revealed that since 1973, advertising restrictions have resulted in much lower rates of smoking (Laugesen & Meads, 1991).

In 1998, the U.S. attorney general negotiated a remarkable settlement with the tobacco industry, calling for the payout of more than $206 billion to the states over the next 25 years, along with severe restrictions on marketing and advertising to children (see Table 6.3). Critics point to the fact that this figure represents a mere 8% of the $2.5 trillion that the federal government will lose over the same 25 years in health care costs related to smoking


(D.Z. Jackson, 1998). In addition, according to the Federal Trade Commission, the tobacco industry actually spent more money on advertising and promotions immediately after the lawsuits were settled: $8.2 billion in 1999, a 22% increase from 1998 (Journal Wire Reports, 2001). Nevertheless, the now-substantial cigarette advertising research is hardly moot and may certainly have implications for alcohol advertising as well. For example, will there be future lawsuits by attorneys general to recover health care costs? In addition, the research may come back into play if the attorney general settlement is overturned by a federal court decision, or by a Congress that has traditionally been heavily influenced by tobacco money. What may replace concerns about advertising and promotion is increasing alarm over depictions of tobacco use in movies, music videos, and television programs—in a sense, the new “advertising” arena for tobacco companies.

Cigarettes in Television Programming, in Music and Music Videos, in Movies, and on the Internet

A report from the National Cancer Institute in 2008 concluded that “the total weight of evidence from cross-sectional, longitudinal, and experimental studies indicates a causal relationship between exposure to depictions of smoking in movies and youth smoking initiation” (Davis et al., 2008, p. 12). In 2011, the World Health Organization issued a report seconding this conclusion and calling for a comprehensive ban on tobacco advertising, promotion, and sponsorship and substantial reductions in smoking imagery in all film media (WHO, 2011). Although the amount of smoking in movies may now be decreasing, new research shows that it may be one of the leading factors in adolescents’ decision of whether to smoke or not (Davis et al., 2008; Sargent, Gibson, et al., 2009; Titus-Ernstoff, Dalton, Adachi-Mejia, Longacre, & Beach, 2008).

Hollywood seems to use cigarette smoking as shorthand for troubled or antiestablishment characters, but the smoking or nonsmoking status of the actors themselves is also influential in whether their characters will smoke on screen (Shields, Carol, Balbach, & McGee, 1999). Until the Surgeon General’s report on smoking in 1957, there was a long tradition of movie stars smoking onscreen and off (see Figures 6.11 and 6.13). Smoking among male characters is associated with violent behavior and dangerous acts; among females, it is associated with sexual affairs, illegal activities, and reckless driving (Heatherton & Sargent, 2009). Movie depictions also tend


to be very pro-smoking, with only 14% of screen time dealing with adverse health effects (Stockwell & Glantz, 1997). Of the 100 top-grossing films of 2002, less than 1% of the smoking incidents depicted the fatal consequences of smoking (Dozier, Lauzen, Day, Payne, & Tafoya, 2005).

Figure 6.13 Hollywood stars in the 1940s and 1950s were often seen smoking onscreen and off. (Humphrey Bogart died from throat cancer; John Wayne died from lung cancer.)

In previous decades, teenagers constituted 26% of the moviegoing audience but only 16% of the U.S. population (Rauzi, 1998). For many years, content analyses have found that a large proportion of American movies contain cigarette smoking. For example, in a study of the 100 top- grossing films from 1996 through 2004, researchers found that half of all R- rated movies (as well as 26% of PG-13 and 17% of PG movies) contained tobacco use (Tickle, Beach, & Dalton, 2009). From 1998 to 2004, nearly three-quarters of the top 100 box office hits contained smoking, and each movie had been seen by 25% of the 6,500 teenagers surveyed nationwide. That adds up to billions of smoking images overall and 665 per 10- to-14- year-old (Sargent, Tanski, & Gibson, 2007). Even G-rated movies can contain tobacco use (Goldstein, Sobel, & Newman, 1999; Yakota & Thompson, 2001) (see Table 6.8), although exposure to smoking in these films may not be as harmful (Lochbuehler, Sargent, Scholte, Pieters, & Engels, 2012). However, three recent analyses—of the 25 top-grossing movies each year from 1990 to 2007, the 30 top-grossing movies from 1950 to 2006, and the 137 top-grossing movies from 2005 to 2010—have found


that smoking occurrences have decreased significantly in the last few years (CDC, 2011; Jamieson & Romer, 2010; Sargent & Heatherton, 2009) (see Figure 6.14). In 2011, this downward trend may have ended: A study of the 134 top-grossing movies found that total tobacco incidents per movie rose 7% from 2010 to 2011. Most alarming was the increase in tobacco incidents in G- and PG-rated movies (Glantz, Iaccopucci, Titus, & Polansky, 2012).

Table 6.8 Tobacco or Alcohol Content of G-Rated Children’s Films

SOURCE: Adapted from Goldstein, Sobel, and Newman (1999).

Figure 6.14 Number of tobacco incidents in top-grossing movies, by movie rating—United States, 1991–2010.


SOURCE: Centers for Disease Control and Prevention (2011).

As tobacco smoking in movies has decreased, so has the prevalence of smoking among adolescents (Sargent & Heatherton, 2009) (see Figure 6.15). Meanwhile, in Europe, tobacco imagery is still very common in popular films: A study of the most commercially successful films in six European countries between 2004 and 2009 found that 87% of “youth- rated” films contained smoking, compared with only 67% in the U.S. (Hanewinkel, Sargent, Karlsdottir, et al., 2012).

• A number of correlational and longitudinal studies have confirmed that exposure to smoking in the media is one of the key factors prompting teenagers to smoke. It may account for up to one-third of smoking initiation in young teenagers (Dalton et al., 2002). Public health advocates estimate that smoking portrayals in movies lead 300,000 adolescents to begin smoking each year, resulting in nearly $1 billion in profit for the tobacco industry (Alamar & Glantz, 2006; Charlesworth & Glantz, 2005). In fact, exposure to movie smoking may even trump parents’ smoking status as being the key factor in adolescents’ initiation of smoking (Titus-Ernstoff et al., 2008).

• Many large, recent European cross-sectional and cohort studies have found robust associations between onscreen smoking and adolescent smoking (S.J. Anderson, Millett, Polansky, & Glantz, 2010; Hanewinkel et al., 2010; Hunt, Henderson, Wight, & Sargent, 2011;


Morgenstern, Poelen, et al., 2011; Waylen, Leary, Ness, & Tanski, 2011). European movies may actually contain more smoking than American movies; 85% of the 464 most commercially successful movies between 2004 and 2009 that portrayed smoking were “youth” rated, compared with 59% in the U.S. (Hanewinkel, Sargent, Karlsdottir, et al., 2012). In India, a cross-sectional study of nearly 4,000 adolescents 12 to 16 years old found a significant association between exposure to tobacco use in Bollywood movies and onset of adolescent smoking (Arora et al., 2011).

Figure 6.15 Comparison of trends for adolescent smoking and smoking in movies, 1990–2007.


SOURCE: Sargent and Heatherton (2009). Copyright © AMA. Reprinted with permission.

• A prospective study of more than 3,500 teenagers found that exposure to R-rated movies doubles the risk of smoking, even when controlling for all other known factors (Dalton et al., 2002) (see Figure 6.16). Even exposure to movie trailers in movie theaters or on TV may increase the lure of cigarettes (Hanewinkel, 2009).


• A study of 735 adolescents 12 to 14 years old, with a two-year follow-up, found that exposure to R-rated movies and having a TV set in the bedroom significantly increased the risk of smoking initiation for White teens but not for Black teens (C. Jackson, Brown, & L’Engle, 2007). This is now the third longitudinal study documenting the risk of R-rated movies (Dalton et al., 2003; C. Jackson et al., 2007; Sargent et al., 2005).

• Five other longitudinal studies have documented the risk for youth of seeing smoking in movies of all ratings (Sargent, Stoolmiller, Worth, Gibson, & Gibbons, 2007; Sargent et al., 2012), including for German preteens and teens (Hanewinkel & Sargent, 2007, 2009) and elementary schoolchildren (Titus-Ernstoff et al., 2008). PG-13 movies—not R-rated movies—actually accounted for about two- thirds of the population effect in the most recent study (Sargent et al., 2012).

• A unique experimental study with 358 youth 11 to 14 years old found that preteens and teens exposed to movie scenes that depicted characters smoking for either social motives or relaxation were at particular risk for future smoking (Shadel et al., 2012).

Unfortunately, the most comprehensive content analyses that have examined substance use on television are now 10 years or more old and need updating (Christenson et al., 2000; DuRant et al., 1997). A study of the top-rated TV series for 12- to 17-year-olds found that 40% of episodes had at least one depiction of tobacco use, and shows rated TV-PG actually had more smoking incidents (50%) than those rated TV-14 (26%) (Cullen et al., 2011). Self-reported exposure to pro-tobacco messages in various media have apparently declined from 2000 to 2004, except on the Internet. Still, 81% of 6th to 12th graders reported seeing images of smoking on TV or in movies (down from 90% previously) and 33% saw tobacco ads on the Internet (up from 22%) in three very large longitudinal samples (Duke et al., 2009). The first 18 seasons of The Simpsons contained an average of two smoking depictions per episode (Eslick & Eslick, 2009). Reality shows like The Osbournes frequently featured content endorsing tobacco use (Blair, Yue, Singh, & Bernhardt, 2005). On British TV, one content analysis found smoking-related scenes to occur at a rate of 3.4 instances per hour (Cumberbatch & Gauntlett, 2005). But generally, tobacco portrayals on TV are outnumbered by portrayals of alcohol and illicit drugs: On prime-time TV, 16% of all episodes studied in one analysis featured smoking and 29% illicit drug use, but one-third featured alcohol (Murphy, Hether, & Rideout,



Figure 6.16 Does smoking in movies increase the risk of teen smoking?

SOURCE: Charlesworth and Glantz (2005). Reproduced with permission from Stanton A. Glantz.

Clearly, movies currently represent the greatest risk factor for teenagers, but a few studies have found a relationship between viewing smoking on TV and initiation of smoking. An older, two-year longitudinal study found a nearly sixfold risk of smoking initiation with more than five hours of TV viewing per day (Gidwani, Sobol, DeJong, Perrin, & Gortmaker, 2002). A more recent cross-sectional study found a similar dose-response relationship (Gutschoven & Van den Bulck, 2004). Nearly all children and teenagers have seen tobacco use on TV in the form of movie trailers (Healton, Watson-Stryker, & Allen, 2006), and one study found that such trailers increase the attractiveness of smoking for young people (Hanewinkel, 2009). Only a single study has examined the impact of TV on adult smoking—a unique 26-year longitudinal study in New Zealand that followed an unselected cohort of 1,000 individuals from birth. Researchers found that heavy TV viewing in childhood correlated with smoking at age 26 and that 17% of the variance in adult smoking might be attributable to the influence of excessive TV viewing during childhood (Hancox, Milne, & Poulton, 2004).

In music videos, smoking seems to have taken a backseat to more illicit


substances (Gruber, Thau, Hill, Fisher, & Grube, 2005). Similarly, an analysis of the 279 most popular songs from 2005 found that only 3% mentioned tobacco use, whereas 24% mentioned alcohol use and 14% mentioned marijuana use (Primack, Dalton, Carroll, Agarwal, & Fine, 2008).

On the Internet, tobacco may not be as much of a problem currently—but that could change. A study involving 346 teenagers viewing 1.2 million webpages found that less than 1% of the pages contained tobacco content, much of which was anti-tobacco anyway. However, more than half of the content was from social networking sites, especially MySpace (Jenssen, Klein, Salazar, Daluga, & DiClemente, 2009). For many years teenagers could purchase cigarettes easily online (J. A. Bryant, Cody, & Murphy, 2002). The Preventing Illegal Internet Sales of Cigarettes and Smokeless Tobacco (PACT) Act would prevent that and was recently passed by Congress (Campaign for Tobacco-Free Kids, 2010; Cruz & Deyton, 2010). The Tobacco Control Act also contains provisions to address this by 2012 (see Table 6.4).

However, tobacco companies been spending more on Internet advertising; the figure increased from $125,000 in 1998 to $17.8 million in 2008 (Campaign for Tobacco-Free Kids, 2011). A 2010 study found that British American Tobacco employees were using social networking sites like Facebook to promote their products, especially in countries where advertising is banned (Freeman & Chapman, 2010). YouTube has also become a new source of pro-tobacco videos and tobacco imagery (Forsyth & Malone, 2010). One recent and interesting study of more than 1,000 teens found that teens who spend time every day on social networking sites are five times likelier to use tobacco than those who do not visit such sites (National Center on Addiction and Substance Abuse, 2011b) (see Figure 6.17).

Figure 6.17 Teen tobacco, alcohol, and marijuana use.


SOURCE: National Center on Addiction and Substance Abuse at Columbia University (2011b). Reprinted with permission.


Research on Alcohol Advertising Although the research on alcohol advertising is not quite as compelling as

that on tobacco advertising, children and teenagers are uniquely vulnerable audiences. Beer ads often seem custom made to appeal to preteens and teens, with images of fun-loving, sexy, successful young adults having the time of their lives (Borzekowski & Strasburger, 2008; Chen, Grube, Bersamin, Waiters, & Keefe, 2005). Who wouldn’t want to indulge, especially when the ads make it seem as if everyone drinks (see Table 6.9)? Alcohol ads frequently feature sexual and social stereotypes that target teenagers (Austin & Hust, 2005) (see Figure 6.18). Youth ages 12 to 20 are 22 times more likely to see a product advertisement for alcohol than an alcohol-industry funded “responsibility” message (Center on Alcohol Marketing and Youth, 2010b).

The density of alcohol ads and the exposure of children and teens to them is a major concern: The average young person in the U.S. sees nearly 2,000 annually on TV alone (Jernigan, 2006; Strasburger & Council on


Communications and Media, 2010a)—more than adults see and an increase of 71% from 2001 to 2009 (Center on Alcohol Marketing and Youth, 2010b). Similarly, in Australia, teens’ overall exposure to alcohol advertising exceeds adults’ exposure (Winter, Donovan, & Fielder, 2008). Often, this advertising is concentrated in teen shows or sports programming. All of the top 15 teens shows in the early 2000s contained alcohol ads (Center on Alcohol Marketing and Youth, 2004). Ads are also frequently embedded in sports programming—on banners, on scoreboards, or emblazoned on race cars (Nicholson & Hoye, 2009). Even hard liquor is now being advertised on TV for the first time in years (Semuels, 2009).

Table 6.9 Seven Myths That Alcohol Advertisers Want Children and Adolescents to Believe

SOURCE: Adapted from Kilbourne (1993).

Figure 6.18 Alcohol ads frequently feature sexual and social stereotypes that target teenagers.


For many years, alcoholic beverages popular with underage drinkers were disproportionately advertised in magazines with a higher youth readership (King et al., 2009). However, in recent years, magazine advertising may have been curtailed by the industry’s voluntary standard that now restricts ads in media where the youth audience exceeds 30%. Consequently, youths’ exposure has dropped significantly (CDC, 2007) (see Figure 6.19). From 2001 to 2008, alcohol advertising in youth-oriented magazines decreased 48% (Center on Alcohol Marketing and Youth, 2010a). But on the radio—the second most popular medium for teenagers— young people often hear more alcohol ads than adults (Center on Alcohol Marketing and Youth, 2011b). A CDC study found that half of all the nearly 70,000 alcohol ads in 104 major markets around the country were airing on programming with a predominantly adolescent audience (CDC, 2007). A separate study of 75 local radio markets found that 9% of all alcohol ads were airing on programs with underage audiences, in violation of the industry’s own 30% standard. Three brands (Bud Light, Coors Light, and Miller Lite) placed nearly half of the noncompliant ads (Center on Alcohol Marketing and Youth, 2011b).

Figure 6.19 Trends in youth exposure to alcohol advertising in magazines and on television, 2001–2005.


SOURCE: Center on Alcohol Marketing and Youth (2007). Reprinted with permission.

Digital advertising and social networking sites have also come to the forefront (Montgomery & Chester, 2009; Moreno, Briner, Williams, Walker, & Christakis, 2009). In just a six-month period during 2003, teenagers made nearly 700,000 in-depth visits to 55 alcohol websites (Center on Alcohol Marketing and Youth, 2004). According to one survey, more than 3 million teens have a friend who has bought alcohol online, and more than half a million have done so themselves (Hitti, 2006).

Several studies have found significant associations between exposure to alcohol advertising and subsequent consumption (Borzekowski & Strasburger, 2008; Jernigan, 2006, 2009). At least eight cohort studies involving more than 13,000 young people have found modest associations (Gordon, MacKintosh, & Moodie, 2010; Smith & Foxcroft, 2009). Teenagers who obtain alcohol-branded merchandise are more likely to begin drinking (McClure, Stoolmiller, Tanski, Worth, & Sargent, 2009). Adolescents who engage in binge drinking are also more likely to name a favorite brand, which is usually one that is also heavily advertised (Tanski, McClure, Jernigan, & Sargent, 2011). In one large longitudinal study of more than a thousand 6th to 8th graders, those who had never tried alcohol but were receptive to alcohol marketing were 77% more likely to initiate drinking a year later than those who were unreceptive (Henriksen, Feighery, Schleicher, & Fortmann, 2008). Another recent large longitudinal study found a 35% positive change in attitudes toward alcohol with exposure to alcohol advertising (Morgenstern, Isensee, Sargent, & Hanewinkel, 2011a), and a cross-sectional study of more than 3,400 sixth to eighth graders in


Germany found a two- to threefold higher risk of drinking with frequent exposure to alcohol ads (Morgenstern, Isensee, Sargent, & Hanewinkel, 2011b). Finally, a 2013 longitudinal study of 3,890 students found that exposure to alcohol ads in 7th grade was predictive of alcohol use 4 years later, even when other known factors were controlled for (Grenard, Dent, & Stacy, 2013).

Alcohol on TV, in Music and Music Videos, in Movies, and Online

Several content analyses have been done recently that show that alcohol remains prevalent in mainstream American media:

• From 2004 to 2006, one-third of the top 10 prime-time shows featured alcohol, with only 6% showing negative consequences (Murphy et al., 2008).

• A recent analysis of 50 episodes of children’s shows, 50 episodes of “tween” programs (with a 9- to 14-year-old target audience), 40 episodes of soap operas, and 50 episodes of prime-time shows during the 2003 season found as much alcohol content in the tween shows (37%) as in the soaps (33%) and the adult shows (38%) (Greenberg, Rosaen, Worrell, Salmon, & Volkman, 2009). On The O.C., a show popular with preteens and teens, most of the drinking was done by adult women, but one-third did involve adolescents (Van den Bulck, Simons, & Van Gorp, 2008).

• In an analysis of 359 music videos broadcast in 2001, nearly half contained depictions of alcohol (Gruber, Thau, et al., 2005).

• Of the 279 most popular songs of 2005, nearly one-quarter contained references to alcohol use. Rap music had the most alcohol references, with 53% of the songs studied mentioning alcohol (Primack et al., 2008). And a study of the 793 most popular songs for teenagers between 2005 and 2007, according to Billboard magazine, found that 21% contained explicit alcohol references and that a typical teenager listening to an hour of popular music a day on the radio would hear three to four specific brand references (Primack, Nuzzo, Rice, & Sargent, 2012).

• In the UK, the top 10 programs watched by 10- to 15-year-olds in 2004 contained 12 alcohol-related scenes per hour (Cumberbatch & Gauntlett, 2005). In New Zealand, a study of 98 hours of prime-time


TV programs from 2004 found one scene every nine minutes, with positive portrayals of alcohol outnumbering negative ones by a 12 to 1 margin (McGee, Ketchel, & Reeder, 2007).

• An analysis of the 100 top-grossing films for each year from 1996 through 2004 found that half of all R- and PG-13-rated movies and one-fourth of PG-rated movies contained alcohol use (Tickle et al., 2009). A 2006 study found that 92% of a random sample of 601 contemporary movies contained alcohol use (Sargent et al., 2006).

As with cigarette portrayals, alcohol portrayals seem to have an impact on actual use among adolescents (Sargent et al., 2006; Tanski, Dal Cin, Stoolmiller, & Sargent, 2010; Wills, Sargent, Gibbons, Gerrard, & Stoolmiller, 2009). A survey of more than 1,200 Pittsburgh high school students found that exposure to movies was independently associated with alcohol use (Primack, Kraemer, Fine, & Dalton, 2009). Similarly, a longitudinal study of more than 2,700 German students ages 10 to 16 years found that exposure to movie depictions of alcohol use was an independent predictor of alcohol initiation (Hanewinkel & Sargent, 2009). Most recently, a longitudinal study of 2,406 students in 5th to 8th grade who had never used alcohol found that exposure to R-rated movies tripled the likelihood of their having used alcohol when they were resurveyed one to two years later (see Figure 6.20) (Tanski et al., 2010).

A review of seven cohort studies involving more than 13,000 young people found modest but significant association between exposure to alcohol portrayals and subsequent consumption (Smith & Foxcroft, 2009). The most recent cohort sample involved 6,522 ten- to fourteen-year-olds, who were studied four times over a two-year period (Stoolmiller et al., 2012) (see Figure 6.21). An even larger study—of 13 longitudinal studies involving more than 38,000 young people—also concluded that exposure to media and commercial depictions involving alcohol is consistently associated with both an increased likelihood of starting to drink and increased alcohol consumption among teens already drinking (P. Anderson et al., 2009). In Europe, a cross-sectional survey of 16,551 students in six countries found a robust association between alcohol depictions in movies and adolescent binge drinking that was relatively unaffected by cultural contexts (Hanewinkel, Sargent, Poelen, et al., 2012). One creative lab experiment actually exposed young adults to various movies with and without alcohol depictions and observed what they drank while watching. Movies with alcohol content and alcohol commercials resulted in more


alcohol being consumed during viewing (Engels, Hermans, van Baaren, Hollenstein, & Bot, 2009).

Social networking sites represent new ways of reaching teenagers and— intentionally or unintentionally—exerting peer pressure on them to begin drinking. The 10 leading alcohol brands have nearly 7 million people “liking” their Facebook pages. These brands have uploaded more than 35,000 photos and 375 videos to their Facebook pages (Center on Alcohol Marketing and Youth, 2011a). A study of 500 MySpace profiles of 18-year- olds found that 41% referenced substance use (Moreno, Parks, Zimmerman, Brito, & Christakis, 2009). Another, similar study of four hundred 17- to 20- year-olds’ profiles found that 56% contained references to alcohol (Moreno et al., 2010). Teens who reference alcohol on their profiles are more likely to engage in problem drinking (Moreno, Christakis, Egan, Brockman, & Becker, 2012; Moreno, Grant, Kacvinsky, Egan, & Fleming, 2012), and teens who see peers’ profiles that describe alcohol adventures are more likely to view drinking as normative behavior (Litt & Stock, 2011). In two recent NCASA Columbia surveys, 40% of all teens surveyed had seen pictures on Facebook or other social networking sites of kids getting drunk or passed out (National Center on Addiction and Substance Abuse, 2011b, 2012). Often, these pictures are seen at a young (and therefore impressionable) age (see Figure 6.22). Compared with teens who did not access social networking sites in a typical day, teens who did were four times likelier to have used marijuana, more than three times likelier to have used alcohol, and almost three times likelier to have used tobacco (National Center on Addiction and Substance Abuse, 2012) (see Figure 6.23). Note that these are cross-sectional data only, however. Finally, unlike cigarettes, alcohol can still be purchased illegally by teens online; of 100 orders placed online by underage buyers, 45% were successfully received (Williams & Ribisl, 2012).

Figure 6.20 Exposure to movie alcohol use and drinking incidence.


SOURCE: Data based on Sargent and colleagues (2005); Sargent, Worth, Beach, Gerrard, and Heatherton (2008).

Figure 6.21 Alcohol onset and progression to binge drinking.


SOURCE: Stoolmiller and colleages (2012). Reprinted with permission.

Figure 6.22 Age of teens when they first saw pictures of kids drunk, passed out, or using drugs on a social networking site.

SOURCE: National Center on Addiction and Substance Abuse at Columbia University (2011b).


Reprinted with permission.

Figure 6.23 Association between seeing pictures of teens using drugs, getting drunk or passed out and teen substance use.

SOURCE: National Center on Addiction and Substance Abuse at Columbia University (2012). Reprinted with permission.

Illicit Drugs Illicit drugs are rarely seen on TV (Christenson et al., 2000), with the exception of programs like Showtime’s Weeds and Shameless, HBO’s Entourage, and FOX’s That 70s Show. But teens with a TV in their own bedroom have a far greater likelihood of engaging in risky health behaviors, such as sexual activity or using tobacco, marijuana, or alcohol (Gruber, Wang, et al., 2005; Hanewinkel & Sargent, 2009).

Drug scenes are more common in movies (22% of movies in one study contained drug scenes), where more than half of the time no harmful consequences are shown (Roberts & Christenson, 2000). Marijuana is the most frequent drug seen in movies and seems to be making a comeback in R- rated movies like the Harold and Kumar series, Totally Baked (2007), Pineapple Express (2008), The Hangover Part II (2011), and Bad Teacher (2011) (Halperin, 2008). A Columbia study found that viewing R-rated movies was associated with a sixfold higher risk of trying marijuana (National Center on Addiction and Substance Abuse, 2005) (see Figure 6.24). Hollywood filmmakers do not seem to understand that humor tends to


undermine normal adolescent defenses against drugs and legitimizes their use (Borzekowski & Strasburger, 2008). Increased consumption of popular music is also associated with marijuana use (Primack, Kraemer, Fine, & Dalton, 2009; Primack, Douglas, & Kraemer, 2010).

In rap music, the prevalence of drug mentions and behavior has increased sixfold over the past several decades, with marijuana predominating (two- thirds of instances). Drug use in rap music has come to signify wealth and sociability, and attitudes toward drugs have changed from negative to positive (Herd, 2008). In one study, 77% of rap songs contained portrayals of substance use (Primack et al., 2008). Teens may hear as many as 84 drug references daily in popular songs (Primack et al., 2008) (see Figure 6.25). Music videos have paralleled this trend, with rap and hip-hop videos containing two to three times more alcohol and illicit substance mentions than other genres (Strasburger & Council on Communications and Media, 2010a). Overall, nearly half of music videos examined in one study contained alcohol, tobacco, or other drugs of abuse, with alcohol present in 35%, tobacco in 10%, and illicit drugs in 13% (Gruber, Thau, et al., 2005).

Figure 6.24 Percentage of teens who have tried cigarettes, alcohol, or marijuana.

SOURCE: National Center on Addiction and Substance Abuse at Columbia University (2005).

Figure 6.25


SOURCE: Zits © 1998 Zits Partnership. Dist. by King Features Syndicate.

Two new reports also implicate new media in teen drug use. A survey of more than a thousand 12- to 17-year-olds found that teens who spend time daily on social networking sites are twice as likely to use marijuana (National Center on Addiction and Substance Abuse, 2011b). In addition, there are more than 350 websites advertising or selling controlled prescription drugs, and 85% of the sites do not require a prescription (National Center on Addiction and Substance Abuse, 2008).

A Word About Prescription and Nonprescription Drugs Currently, the only countries in the world that allow advertising of prescription drugs are the U.S. and New Zealand. In the U.S., nearly $30 billion is spent annually on promotion of a variety of prescription drugs, including $4.4 billion on advertising (Donohue, Cevasco, & Rosenthal, 2007; Rubin, 2009). In direct-to-consumer advertising, erectile dysfunction drugs lead the way; whereas statins and psychotropic drugs are most commonly marketed to healthcare professionals (Congressional Budget Office, 2009) (see Figure 6.26). The FDA has just 57 officials who are tasked with reviewing approximately 75,000 ads and marketing items a year. In 2010, they began a “Bad Ad” campaign to enlist doctors to help in spotting and reporting questionable ads or promotions (Heavey & Richwine, 2010).

In 2000, Merck spent more money advertising Vioxx ($161 million) than Dell, Budweiser, Pepsi, or Nike spent (Rosenthal, Berndt, Frank, Donohue, & Epstein 2002). Drug companies now spend more than twice as much


money on marketing and promotion as they do on research and development, and studies show that these marketing efforts pay off (Rosenthal et al., 2002); a survey of physicians found that 92% of patients had requested an advertised drug (Thomaselli, 2003). Direct-to-consumer advertising has remained controversial since the FDA first approved of it in 1997 (Frosch, Grande, Tarn, & Kravitz, 2010; Gellad & Lyles, 2007). American TV viewers see as many as 16 hours of prescription drug ads per year (Frosch, Krueger, Hornik, Cronholm, & Barg, 2007). Emotional appeals are almost universal, and the ads provide only limited educational information (Frosch et al., 2007). Children and teenagers get the message that there is a pill to cure all ills, and a drug for every occasion, including sexual intercourse (Borzekowski & Strasburger, 2008). In the first 10 months of 2004 alone, drug companies spent nearly half a billion dollars advertising Viagra, Levitra, and Cialis (Snowbeck, 2005) (see Figure 6.27). Yet the advertising of condoms, birth control pills, and emergency contraception is haphazard and rare and remains controversial (Strasburger and Council on Communications and Media, 2010b).

Figure 6.26 Spending for DTC advertising and detailing to health care professionals among the 10 drug classes in CBO’s data set with the highest dtc spending, 2008.

SOURCE: Congressional Budget Office Based on data from SDI Promotional Audits.

NOTES: Detailing refers to the practice in which pharmaceutical representatives make sales calls to physicians and other health care professionals to discuss the uses of a particular prescription drug and its benefits for patients


DTC = direct to consumer: SNRI = serotonin-norepinephrine reuptake inhibitors.

Figure 6.27 Drug companies spend billions of dollars advertising drugs for erectile dysfunction.

Solutions In the past three decades, when “Just say no” has become the watchword for many parents, school-based drug prevention programs, and federal drug prevention efforts, unprecedented amounts of money are being spent to induce children and adolescents to “just say yes” to tobacco and alcohol. Perhaps, as one group of researchers has suggested, the “discussion [should] be elevated [emphasis added] from the scientific and legal arenas to the domain of ethics and social responsibility” (Orlandi et al., 1989, p. 92) (see Table 6.10). Below are eight possible approaches that could very well result in significant reductions in adolescent cigarette, alcohol, and drug use.

Table 6.10 Newspapers and Magazines That Refuse Cigarette Advertising (partial listing)


1. A ban on cigarette advertising in all media and effective restrictions on alcohol advertising. Any product as harmful as tobacco should have severe restrictions placed on it (Committee on Environmental Health, Community on Substance Abuse, Committee on Adolescence, and Committee on Native American Child Health, 2009; Kunkel, 2007; Strasburger and Council on Communications and Media, 2010a). An increasing number of countries are banning all tobacco advertising in all media (Prokhorov et al., 2006). Are such bans effective? One study of 30 developing countries found that partial bans reduced consumption 13.6%, while complete bans reduced consumption 23.5% (Blecher, 2008).

On the other hand, a total ban on all alcohol advertising would be both impractical and unproductive, and probably illegal as well. Unlike cigarettes, alcohol may have legitimate uses when consumed in moderation. But restricting alcohol advertising in programming for youth audiences to less than 15% would be an easily achievable and significant step (Center on Alcohol Marketing and Youth, 2007), and it would result in a 20% reduction in teens’ exposure to alcohol ads and would result in alcohol manufacturers being able to reduce their advertising costs by 8% (Jernigan, 2006; Jernigan, Ostroff, & Ross, 2005). In turn, reducing adolescents’ exposure to alcohol ads could reduce their alcohol consumption by as much as 25% (Saffer & Dave, 2006). In 2007, a report by the U.S. Surgeon General supported reducing alcohol ads in venues popular with young people (U.S Department of Health and Human Services, 2007); and in 2011, 24 state attorneys general sent a letter to the Federal Trade Commission supporting the 15% standard (Join Together Staff, 2011).


Alternatively, beer and wine manufacturers could be restricted to so-called “tombstone ads” (an industry term for ads that show only the product, not the sexy beach babes or funny talking animals) (Chen et al., 2005; Strasburger & Council on Communications and Media, 2010a). A return to banning direct-to-consumer prescription drug marketing should be considered as well (Stange, 2007).

2. Higher taxes on tobacco and alcohol products. Taxes have a direct and immediate effect on the consumption of products, particularly by teenagers (U.S. Department of Health and Human Services, 1994). For cigarettes, every 10% increase in the price will reduce underage smokers by 6% to 7% (Campaign for Tobacco-Free Kids, 2009b).

Figure 6.28 Examples of counteradvertising.

SOURCE: Partnership for a Drug-Free America and MADD.

Figure 6.29 Graphic cigarette pack warning labels proposed by the FDA.


3. More aggressive counteradvertising. Counteradvertising has been shown to be effective, but only if it is intensive, thoughtfully planned, and uses a variety of different media (Flynn et al., 2007; Ibrahim, & Glantz, 2007; Noar, 2006) (see Figure 6.28). For example, a four- year, $50 million campaign in Massachusetts resulted in a 50% reduction in the new onset of smoking by young teens (Siegel & Biener, 2000). Antismoking ads may be particularly effective for young children (Nixon, Mansfield, & Thoms, 2008). In 2011, the FDA announced that it will spend $600 million over the next five years on TV and print ads and via social media to try to educate the public about the dangers of tobacco use (Bacon, 2011). It has also revealed nine new large, graphic cigarette warning labels under the agency’s new powers to regulate tobacco products (Young, 2011) (see Figure 6.29), but the tobacco industry is already challenging the constitutionality of the labels on First Amendment grounds (Outterson, 2010). In 2012, a U.S. court of appeals issued a two-to-one decision that the labels would violate corporate free speech rights—a ruling that contradicted another appellate court decision and sets up the possibility that the U.S. Supreme Court will take the case (Bayer, Gostin, & Marcus-Toll, 2012; Reuters, 2012).


For current smokers, new brain imaging technology (functional magnetic resonance imaging) has found that low-key antismoking ads may actually be preferable to attention-grabbing ads (Langleben et al., 2009). By contrast, graphic warning labels may be effective (Strasser, Tang, Romer, Jepson, & Cappella, 2012). However, the biggest hurdle is that rarely, if ever, does the occurrence rate of counteradvertising come close to that of regular advertising and promotions and scenes of tobacco use on TV, in the movies, and online.

The three best-known counteradvertising efforts have done by the Partnership for a Drug-Free America (PDFA), the White House Office of National Drug Control Policy (ONCDP), and the Truth campaign: • A study of PDFA ads found that more than 80% of nearly 1,000

public school students ages 11 to 19 could recall such ads, and half of the students who had tried drugs reported that the ads actually convinced them to decrease or stop using drugs (Reis, Duggan, Adger, & DeAngelis, 1992). However, a more recent study questioned the effectiveness of PDFA ads. A nationally representative sample of more than five thousand 9- to 18-year- olds was surveyed four times between 1999 and 2004. Although substantial exposure to antidrug advertising was achieved (94% of youths reported exposure to one or more ads per month, with a media frequency of about two to three per week), there was no change in prevalence of marijuana use and some evidence for a possible boomerang effect (Hornik, Jacobsohn, Orwin, Piesse, & Kalton, 2008). Unfortunately, not a single PDFA ad has ever aired that targets either tobacco or alcohol. Similarly, Congress has given nearly $1 billion to the Office of National Drug Policy Control (ONDCP) for the National Youth Anti-Drug Media Campaign, which has included partnering with the PDFA (Hornik et al., 2008) (see Figure 6.30), but so far not a single ad has targeted tobacco or alcohol—a remarkable finding, given that tobacco and alcohol represent the two most significant drug threats to children and adolescents (Strasburger and Council on Communications and Media, 2010a). Effects of the 2002 “My Anti-Drug” campaign actually showed increased marijuana use among teenagers (Hornik et al., 2008). The ONDCP’s new campaign, “Above the Influence,” began in 2005 (see Figure


6.31), and two studies have shown some efficacy; exposure to the ads predicted reduced marijuana use among both male and female 8th graders in one study (Slater et al., 2011) but among only female 8th graders in a study of 8th-, 10th-, and 12th-grade males and females (Carpenter & Pechmann, 2011). Certainly, it may be unrealistic to expect antidrug advertising campaigns to have a major impact on teen use, given the multifactorial nature of adolescent drug use and the multitude of media influences (Terry- McElrath et al., 2010).

Figure 6.30 NYADMC and PDFA media campaigns.

SOURCE: Terry-McElrath, Emery, Szczypka, and Johnston (2010). Reprinted with permission.

• As part of the tobacco industry’s $246 billion Tobacco Master Settlement Agreement (see Table 6.3), the nonprofit American Legacy Foundation was established, which produces the “Truth” ads. Such ads often try to expose the tobacco industry as being manipulative and deceptive (see Figure 6.32). In one ad, two teenagers carry a lie detector into Philip Morris’s New York headquarters and announce that they want to deliver it to the marketing department. In another, a group of teens in a large delivery truck pull up in front of headquarters and begin unloading body bags. One teen shouts through a megaphone, “Do you know


how many people tobacco kills every day?” (A. Bryant, 2000). The ads are so hard-hitting that Philip Morris actually insisted that two be withdrawn. Yet in Florida, they accounted for one- fourth of the decline in the prevalence of teen smoking from 25% in 1999 to 18% in 2002 (Farrelly, Davis, Haviland, Messeri, & Healton, 2005). By contrast, ads made by Philip Morris as part of their $100 million campaign cautioning teens to “Think. Don’t smoke” are ineffectual and may be a “sham” (“Big Tobacco’s Promises,” 2006; Henriksen, Dauphinee, Wang, & Fortmann, 2006; Paek & Gunther, 2007).

Figure 6.31 Ad from “Above the Influence” campaign.

Citizens and policymakers should reject any “educational” programs by the tobacco industry. If the tobacco industry were sincere in its stated desire to contribute to reducing youth smoking, it would stop opposing policies and programs that have been demonstrated to be effective. (Landman et al., 2002, p. 925)

A few years ago, the Motion Picture Association of America (MPAA) agreed to include an antismoking ad on all new DVDs


(Serjeant, 2008). Airing antismoking ads just before showing big Hollywood movies that feature a lot of smoking would also be effective (Edwards, Harris, Cook, Bedford, & Zuo, 2004; Edwards, Oakes, & Bull, 2007), but this is not currently being done. The 15- minute period prior to movie previews is actually under the control of local theater owners, not Hollywood, so this would be feasible (Heatherton & Sargent, 2009). Hollywood filmmakers need to stop using smoking as a shorthand device for an evil or conflicted character, and film school students need to be educated about the health effects of what they produce (Chapman, 2008). In 2007, Disney actually vowed to discontinue all smoking in its movies (“Up in Smoke,” 2007) (see Table 6.11).

Figure 6.32 “Truth” ad from the American Legacy Foundation.

4. Increased sensitivity and awareness of the entertainment industry to the health-related issues of smoking, drinking, and other drug use in TV programming, movies, music and music videos, and video games. Ideally, people in the entertainment industry would understand that with the billions of dollars they make each year comes a public health responsibility; sadly, most of the time they do not (Strasburger, 2009a). They are exceptions, however. The old Beverly Hills, 90210 was conscientious in avoiding gratuitous drug use and showing the


consequences instead. Ferris Bueller’s Day Off was intentionally smoke-free in 1986, and so was The Devil Wears Prada in 2006. In the UK, old cartoons such as Tom and Jerry, The Flintstones, The Jetsons, and Scooby-Doo are now being edited to eliminate smoking scenes (“British Channel Bans,” 2006). Prosocial content does not have to interfere with storylines, and it can contribute significantly to young people’s notions about health (Hogan & Strasburger, 2008; Kaiser Family Foundation, 2004). The idea that being drunk is funny is a myth that needs to be seriously reexamined by the entertainment industry and could easily be contributing to the high rates of binge drinking among teens (Miller, Naimi, Brewer, & Jones, 2007) (see Figure 6.33). Rock music lyrics and music videos could avoid glamorizing drinking or getting drunk (Council on Communications and Media, 2009). Teen-oriented shows and channels like MTV and BET could lead the way by developing more prosocial programming and by airing antismoking and anti-alcohol PSAs. Of course, according to one group of researchers, there may not be a problem to begin with—TV characters use drugs less often than the actual U.S. population does (Long, O’Connor, Gerbner, & Concato, 2002)!

Table 6.11 Four Steps to Reducing Youth Exposure to Smoking in Movies

SOURCE: Bonnie, Stratton, and Wallace (2007);

Figure 6.33 Getting drunk isn’t funny.


SOURCE: © Distilled Spirits Council of the United States.

5. Revision of the ratings systems for both television and movies. As discussed in Chapter 13, several studies show that parents would prefer a universal ratings system that would apply to movies, TV, and video games, one that would be more specific and content based (Greenberg, Rampoldi-Hnilo, & Mastro, 2000; Walsh & Gentile, 2001). A recent survey of more than 3,000 adults nationwide found that 70% support an R rating for movies that depict smoking (see Figure 6.34), and two-thirds would like to see antismoking PSAs before any film that depicts smoking (McMillen, Tanski, Winickoff, & Valentine, 2007). According to one recent study, an R rating for smoking would reduce adolescent smoking onset by nearly 20%, since smoke-free PG-13 movies would come into the market (currently, PG-13 movies actually feature more smoking incidents than R-rated movies) (Sargent et al., 2012). In May 2007, the MPAA announced that it would consider cigarette smoking in their ratings


scheme (MPAA, 2007), but it is unclear how exactly this will play out (Pupillo, 2007).

Figure 6.34 Americans support an R rating for movies that depict smoking.


SOURCE: Reprinted with permission.

NOTE: Some critics have proposed that an R rating be given by the Motion Picture Association of America (MPAA) for tobacco use in films. An alternative solution would be to have all movie sets declared smoke-free because secondhand smoke is an occupational health hazard.

3. Increased sensitivity to media effects and increased media literacy. A century ago, to be “literate” meant that you could read and write. In the year 2013, to be literate means that you can read and write, text, download, tweet, and successfully understand and “decode” a dizzying array of different media and media messages (Rich & Bar- on, 2001). Ideally, parents need to begin this process early with their children and understand that a child who watches TV four hours or more a day has a fivefold increased risk of smoking, for example, compared to one who watches less than two hours per day (Gidwani et al., 2002). Similarly, young children exposed to PG-13- and R- rated movies at young ages are at increased risk for both smoking and drinking (Dalton et al., 2006; Dalton et al., 2009; Sargent et al., 2004; Tanski et al., 2009; Tanski et al., 2010; Thompson & Gunther, 2007). A study of more than 6,500 preteens and teens found that, on average, 12.5% of them had seen each of 40 R-rated movies (Worth, Chambers, Nassau, Rakhra, & Sargent, 2008). A four-wave longitudinal study of 6,522 preteens and teens found less smoking among teens whose parents had R-rated movie restrictions (de Leeuw et al., 2011). According to the American Academy of Pediatrics, parents need to avoid screen time for children younger than 2 years old, limit total entertainment screen time to less than 2 hours per day, co-view with their children, carefully monitor what media their children use and watch, and avoid letting young children see PG-13- and R-rated movies (Council on Communications and Media, 2010; Longacre et al., 2009).

Schools can help as well (Strasburger, 2012). Certain drug prevention programs—programs that incorporate media literacy— have been shown to be extremely effective in reducing levels of teen drug use (see Figure 6.35 and Chapter 12), but such programs must go far beyond the Drug Abuse Resistance Education (DARE) approach being used in 75% of public schools across the country (Botvin & Griffin, 2005). DARE tends to employ scare tactics, be very simplistic (see Figure 6.36), and may have boomerang effects


(Lilienfeld, 2007). In 2001, the U.S. Surgeon General cited DARE as being ineffective (U.S. Department of Health and Human Services, 2001). A meta-analysis of 20 different studies and a 10-year follow- up study of 1,002 individuals who received the training in 6th grade both found the program to be ineffective as well (Lynam et al., 1999; Pan & Bai, 2009).

The U.S. is unique among Western nations in not requiring some form of media literacy for its students (J. D. Brown, 2007). Several studies now indicate that successful drug prevention may be possible through this unique route (Austin & Johnson, 1997; Austin, Pinkleton, Hust, & Cohen, 2005; Bickham & Slaby, 2012; Kupersmidt, Scull, & Austin, 2010; Pinkleton & Austin, 2013, in press; Potter, 2010; Primack, Fine, Yang, Wickett, & Zickmund, 2009; Primack, Gold, Land, & Fine, 2006; Primack & Hobbs, 2009; Primack, Sidani, Carroll, & Fine, 2009; Slater et al., 2006; Weichold, Brambosch, & Silbereisen, 2012) (see Chapter 12). In addition, there are now media education programs that can reduce adolescents’ displays of risky behaviors on social networking websites (Moreno, VanderStoep, Parks, Zimmerman, Kurth, & Christakis, 2009).

Figure 6.35 Follow-up results from four published studies: 8th-grade drug use and 12th-grade polydrug use.

SOURCE: Copyright Princeton Health Press. Reprinted by permission.

NOTE: A LST (life skills training) approach to drug prevention has shown dramatic


decreases in adolescents’ use of a variety of drugs, yet has not been implemented in many communities because DARE (Drug Abuse Resistance Education) programs already exist. The LST approach is based on the work of Botvin (see Botvin & Griffin, 2005). By comparison, there is no evidence that the simplistic messages contained in the $226 million DARE program have had any impact (West & O’Neal, 2004), yet DARE has been used in 80% of school systems nationwide (Kalb, 2001). The DARE curriculum has undergone a revision to incorporate some of the LFT principles.

4. More research. Considering how significant the impact of the media is on young people, it seems astounding that more financial resources are not being devoted to media research (Christakis & Zimmerman 2006; Strasburger, Jordan, & Donnerstein, 2012). According to the most recent Kaiser report, children and teens spend more than seven hours per day with a variety of different media (Rideout, 2010), yet the federal government funds only a handful of studies. Currently no foundation funds any media research (the Kaiser Family Foundation announced in February 2010 that it was discontinuing its Program for the Study of Media and Health, which has produced some of the best media research in the past 15 years). New studies of how different teens process drug content in different media are needed, as are continuing studies of the impact of the Internet and of social networking sites. Understanding how media affect audiences differently is critical to better focusing intervention efforts (Austin, Chen, & Grube, 2006; Ringel, Collins, & Ellickson, 2006; Ward, Day, & Thomas, 2010). For example, African American youth are known to be relatively resistant to tobacco advertising, but why this is true is unclear (CDC, 2006; West, Romero, & Trinidad, 2007). Existing research needs to be more widely disseminated as well. A new Surgeon General’s report or National Institute of Mental Health (NIMH) report might prove to be extremely useful to researchers, health professionals, parents, and policymakers and could provide the impetus for increasing funding of research. The last NIMH report on children and media was published in 1982, well before the advent of the Internet, DVRs, cell phones, digital advertising, and social networking sites!

Figure 6.36 DARE advertising tends to be simplistic.


5. Campaign finance reform in Congress. This recommendation may seem strange in a chapter about the effects of media on young people, but four major groups arguably control much of what is media related in Congress—the National Rifle Association (NRA), beer and wine manufacturers, the tobacco industry, and the food industry—and not one has the best interests of the nation’s children and adolescents at heart. Perhaps not coincidentally, violence, drug use, and obesity are three of the leading health problems facing children and adolescents. Congress can control the media and help to make them more healthful, but until they are liberated from their dependence to these special interest groups, American media will remain potentially unhealthy for young people.

Exercises 1. Product placements. You are the new owner of a baseball team in

Milwaukee. The makers of Old Milwaukee Beer come to you, asking if they can help build you a new scoreboard out in center field. You drink Old Milwaukee Beer yourself, and you were born and raised in Milwaukee. They offer to pay for the new scoreboard ($2 million), plus give you an annual fee of $750,000. Should you accept their offer? If, instead, you are a member of the Milwaukee City Council, should you allow this to happen? Would it be legal to ban such advertising from public ballparks? If you were the director of sports


broadcasting for a TV station, would it be ethical for you to instruct the camera operators to avoid showing advertising logos whenever possible?

2. Drugs and the movies #1. You are the heir apparent to Scorsese and Tarantino. A recent graduate of the USC School of Cinematic Arts and only 24 years old, you are being offered a directing assignment by a major studio: a big-budget action thriller with three major stars. But the film centers on an antihero. You, yourself, do not drink alcohol or smoke cigarettes, in part because your mother died from lung cancer and your father died from cirrhosis. How do you depict the antihero without showing him smoking or drinking and without consuming 10 extra pages of script? Will profanity alone accomplish your task?

3. Drugs and the movies #2. You are an Oscar-nominated film director in your 40s, but you have never made a film about the impact of drugs on society. You want this to be the overriding theme of your next film, which you will write, direct, and coproduce. You admired Traffic a great deal. On the other hand, you thought that The Hangover Part II and Blow glamorized cocaine more than they cautioned against its use (although you would still very much like to work with Johnny Depp). Is it possible to make an “issue” film that shows a lot of drug use without glamorizing that use for certain audiences, such as teenagers?

4. Drug advertising #1. Over-the-counter remedies are legal, often useful, and frequently used. How should they be advertised in a way that is both fair and accurate? Try designing sample ads.

5. Drug advertising #2. How could a researcher design a study to determine if the advertising of nonprescription and prescription drugs makes teenagers more likely to use cigarettes, alcohol, or illicit drugs?

6. Adolescents and alcohol. According to national studies, more than 80% of teenagers have tried alcohol by the time they graduate from high school. If you are a filmmaker interested in doing a realistic film about contemporary adolescence, how do you deal with the issue of alcohol, remain socially responsible, attract an adolescent audience, and keep your artistic soul intact?

7. Advertising alcohol and cigarettes. (a) Try to create the most outrageous print ads you can think of for advertising alcohol and cigarettes. (b) Based on what you have learned in this chapter, analyze the two cigarette ads and two alcohol ads in Figure 6.8. Figure 6.37 shows an ad for an actual product called Bad Frog Beer.


Does this ad target youth? If so, should restrictions be placed on where such ads can be displayed? (Note: This is based on an actual court case in New Jersey.)

Figure 6.37 Ad for Bad Frog Beer.

8. Tobacco policy. If tobacco is a legal product, how can a ban on all tobacco advertising be justified? Research the circumstances under which tobacco advertising was taken off TV by the early 1970s.

9. Drug control policy. You are the newly appointed head of the ONDCP in the White House. Your mission is to cut the use of drugs in the United States by 20% within the next four years. Where do you start? With which drugs? Should you engage in discussions with the entertainment industry regarding their portrayals of alcohol and cigarettes? Should you engage in discussions with the tobacco and alcohol industries regarding their use of advertising? Does counteradvertising work? Should the government be in the business of counteradvertising? If so, which media would you target?



Alamar, B., & Glantz, S. A. (2006). Tobacco industry profits from smoking images in the movies [Letter]. Pediatrics, 117, 1462.

Alpert, H. R., Koh, H. K., & Connolly, G. N. (2008). After the Master Settlement Agreement: Targeting and exposure of youth to magazine tobacco advertising. Health Affairs, 27, w503–w512.

Anderson, P., de Bruijn, A., Angus, K., Gordon, R., & Hastings, G. (2009). Impact of alcohol advertising and media exposure on adolescent alcohol use: A systematic review of longitudinal studies. Alcohol and Alcoholism, 44, 229–243.

Anderson, S. J., Millett, C., Polansky, J. R., & Glantz, S. A. (2010). Exposure to smoking in movies among British adolescents 2001–2006. Tobacco Control, 19, 197–200.

Arora, M., Mathur, N., Gupta, V. K., Nazar, G. P., Reddy, K. S., & Sargent, J. D. (2011). Tobacco use in Bollywood movies, tobacco promotional activities and their association with tobacco use among Indian adolescents. Tobacco Control. doi:10.1136/tc.2011.043539

Atkin, C. K. (1995). Survey and experimental research on effects of alcohol advertising. In S. Martin (Ed.), Mass media and the use and abuse of alcohol (pp. 39–68). Rockville, MD: National Institute on Alcohol Abuse and Alcoholism at Columbia University.

Austin, E. W., Chen, M. J., & Grube, J. W. (2006). How does alcohol advertising influence underage drinking? The role of desirability, identification and skepticism. Journal of Adolescent Health, 38, 376– 384.

Austin, E. W., & Hust, S. J. T. (2005). Targeting adolescents? The content and frequency of alcoholic and nonalcoholic beverage ads in magazine and video formats November 1999–April 2000. Journal of Health Communication, 10, 769–785.

Austin, E. W., & Johnson, K. K. (1997). Effects of general and alcohol- specific media literacy training on children’s decision making about alcohol. Journal of Health Communication, 2, 17–42.

Austin, E. W., Pinkleton, B. E., Hust, S. J. T., & Cohen, M. (2005). Evaluation of an American Legacy Foundation/Washington State Department of Health media literacy study. Health Communication, 18, 75–95.

Bacon, J. (2011, November 3). FDA unveils $600m anti-tobacco effort.


USA Today, p. 3A. Bahr, S. J., Hoffmann, J. P., & Yang, X. (2005). Parental and peer influences

on the risk of adolescent drug use. Journal of Primary Prevention, 26, 529–551.

Bayer, R., Gostin, L., & Marcus-Toll, D. (2012). Repackaging cigarettes: Will the courts thwart the FDA? New England Journal of Medicine, 367, 2065–2065.

Bayer, R., & Kelly, M. (2010). Tobacco control and free speech—an American dilemma. New England Journal of Medicine, 362, 281–283.

Belcher, H. M. E., & Shinitzky, H. E. (1998). Substance abuse in children: Prediction, protection, and prevention. Archives of Pediatrics and Adolescent Medicine, 152, 952–960.

Bickham, D. S., & Slaby, R. G. (2012). Effects of a media literacy program in the US on children’s critical evaluation of unhealthy media messages about violence, smoking, and food. Journal of Children and Media, 6, 255–271.

Biener, L., & Siegel, M. (2000). Tobacco marketing and adolescent smoking: More support for a causal inference. American Journal of Public Health, 90, 407–411.

Big Tobacco’s promises to reform go up in smoke [Editorial]. (2006, September 12). USA Today, p. 14A.

Bjork, J. M., Knutson, B., Fong, G. W., Caggiano, D. M., Bennett, S. M., & Hommer, D. W. (2004). Incentive-elicited brain activation in adolescents: Similarities and differences from young adults. Journal of Neuroscience, 24, 1793–1802.

Blair, N. A., Yue, S. K., Singh, R., & Bernhardt, J. M. (2005). Sex, drugs, and rock and roll: Depictions of substance use in reality television: A content analysis of The Osbournes. British Medical Journal, 331, 1517– 1519.

Blecher, E. (2008). The impact of tobacco advertising bans on consumption in developing countries. Journal of Health Economics, 27, 930–942.

Bonnie, R. J., Stratton, K., & Wallace, R. B. (Eds.). (2007). Ending the tobacco problem: A blueprint for the nation. Institute of Medicine of the National Academies. Retrieved from record_id=11795&page=R1

Borzekowski, D. L. G., & Strasburger, V. C. (2008). Tobacco, alcohol, and drug exposure. In S. Calvert & B. J. Wilson (Eds.), Handbook of children and the media (pp. 432–452). Boston, MA: Blackwell.


Botvin, G. J., & Griffin, K. W. (2005). Models of prevention: School-based programs. In J. H. Lowinson, P. Ruiz, R. B. Millman, & J. G. Langrod (Eds.), Substance abuse: A comprehensive textbook (4th ed., pp. 1211– 1229). Philadelphia, PA: Lippincott Williams & Wilkins.

Briones, D. F., Wilcox, J. A., Mateus, B., & Boudjenah, D. (2006). Risk factors and prevention in adolescent substance abuse: A biopsychosocial approach. Adolescent Medicine: State of the Art Reviews, 17, 335–352.

British channel bans smoking cartoons. (2006, August 30). Associated Press. Retrieved from id=2343123

Brooks, F., van der Sluijs, W., Klemera, E., Morgan, A., Magnusson, J., Gabhainn S. N., . . . Currie, C. (2009). Young people’s health in Great Britain and Ireland: Findings from the Health Behaviour in School- Aged Children (HBSC) survey, 2006. Edinburgh, Scotland: University of Edinburgh.

Brown, A., & Moodie, C. (2009). The influence of tobacco marketing on adolescent smoking intentions via normative beliefs. Health Education Research, 24, 721–733.

Brown, J. D. (2007). Media literacy has potential to improve adolescents’ health. Journal of Adolescent Health, 39, 459–460.

Brown, S. A.,McGue, M., & Maggs, J., Schulenberg, J., Hingson, R., Swartzwelder, S., . . . Murphy, S. (2008). A developmental perspective on alcohol and youths 16 to 20 years of age. Pediatrics, 121(Suppl. 4), S290–S310.

Bryant, A. (2000, March 20). In tobacco’s face. Newsweek, pp. 40–41. Bryant, J. A., Cody, M. J., & Murphy, S. (2002). Online sales: Profit

without question. Tobacco Control, 11, 226–227. Campaign for Tobacco-Free Kids. (2009a). Deadly in pink: Big Tobacco

steps up its targeting of women and girls. Retrieved from

Campaign for Tobacco-Free Kids. (2009b). Raising cigarette taxes reduces smoking, especially among kids (and the cigarette companies know it). Retrieved from

Campaign for Tobacco-Free Kids. (2010, January 12). The PACT Act [Fact sheet]. Retrieved from

Campaign for Tobacco-Free Kids. (2011). Tobacco product marketing on the Internet. Retrieved from

488 Carpenter, C. S., & Pechmann, C. (2011). Exposure to the Above the

Influence antidrug advertisements and adolescent marijuana use in the United States, 2006–2008. American Journal of Public Health, 101, 948–954.

Centers for Disease Control. (2013). Vital signs: binge drinking among women and high school girls, 2011. Morbidity and Mortality Weekly Report, 62, 9–13.

Center on Alcohol Marketing and Youth. (2004). Clicking with kids: Alcohol marketing and youth on the Internet. Washington, DC: Author.

Center on Alcohol Marketing and Youth. (2007). Alcohol advertising and youth. Washington, DC: Author.

Center on Alcohol Marketing and Youth. (2010a). Youth exposure to alcohol advertising in national magazines, 2001–2008. Washington, DC: Author.

Center on Alcohol Marketing and Youth. (2010b). Youth exposure to alcohol advertising on television, 2001–2009. Washington, DC: Author.

Center on Alcohol Marketing and Youth. (2011a). Plugged in 24/7: Alcohol advertising & youth in the digital age. Washington, DC: Author.

Center on Alcohol Marketing and Youth. (2011b). Youth exposure to alcohol product advertising on local radio in 75 U.S. markets, 2009. Washington, DC: Author.

Centers for Disease Control and Prevention. (2006). Racial/ethnic differences among youths in cigarette smoking and susceptibility to start smoking—United States, 2002–2004. Morbidity and Mortality Weekly Reports, 55, 1275–1277.

Centers for Disease Control and Prevention. (2007). Youth exposure to alcohol advertising in magazines—United States, 2001–2005. Morbidity and Mortality Weekly Reports, 56, 763–767.

Centers for Disease Control and Prevention. (2008). Tobacco use and the health of young people. Retrieved from

Centers for Disease Control and Prevention. (2009). Cigarette brand preference among middle and high school students who are established smokers—United States, 2004 and 2006. Morbidity & Mortality Weekly Review, 58, 112–115.

Centers for Disease Control and Prevention. (2010). Tobacco use among middle and high school students—United States, 2000–2009. Morbidity


and Mortality Weekly Report, 59, 1063–1068. Centers for Disease Control and Prevention. (2011). Smoking on top-

grossing movies—United States, 2010. Morbidity and Mortality Weekly Reports, 60, 910–913.

Centers for Disease Control and Prevention. (2012a). Vital signs: Drinking and driving among high school students aged > 16 years—United States, 1991–2011. Morbidity and Mortality Weekly Reports, 61, 796–800.

Centers for Disease Control and Prevention. (2012b). Youth Risk Behavior Surveillance—United States, 2011. Morbidity and Mortality Weekly Report, 61(SS–4).

Champion, H. L., Foley, K. L., DuRant, R. H., Hensberry, R., Altman, D., & Wolfson, M. (2004). Adolescent sexual victimization, use of alcohol and other substances, and other health risk behaviors. Journal of Adolescent Health, 35, 321–328.

Chapman, S. (2008). What should be done about smoking in movies? Tobacco Control, 17, 363–367.

Charlesworth, A., & Glantz, S. A. (2005). Smoking in the movies increases adolescent smoking: A review. Pediatrics, 116, 1516–1528.

Cheers & jeers. (2002, February 23). TV Guide. Chen, M. J., Grube, J. W., Bersamin, M., Waiters, E., & Keefe, D. B.

(2005). Alcohol advertising: What makes it attractive to youth? Journal of Health Communication, 10, 553–565.

Chilcoat, H. D., & Anthony, J. C. (1996). Impact of parent monitoring on initiation of drug use through late childhood. Journal of the American Academy of Child and Adolescent Psychiatry, 35, 91–100.

Christakis, D. A., & Zimmerman, F. J. (2006). Media as a public health issue. Archives of Pediatrics and Adolescent Medicine, 160, 446–447.

Christenson, P. G., Henriksen, L., & Roberts, D. F. (2000). Substance use in popular prime-time television. Washington, DC: Office of National Drug Policy Control.

Comings, D. E. (1997). Genetic aspects of childhood behavioral disorders. Child Psychiatry and Human Development, 27, 139–150.

Committee on Communications. (2006). Children, adolescents, and advertising. Pediatrics, 118, 2563–2569.

Committee on Environmental Health, Committee on Substance Abuse, Committee on Adolescence, and Committee on Native American Child Health. (2009). Pediatrics, 124, 1474–1487.


Committee on Substance Abuse. (2010). Alcohol use by youth and adolescents: A pediatric concern. Pediatrics, 125, 1078–1087.

Congressional Budget Office. (2009). Promotional spending for prescription drugs. Washington, DC: Author.

Cortese, D. K., Lewis., M. J., & Ling, P. M. (2009). Tobacco industry lifestyle magazines targeted to young adults. Journal of Adolescent Health Care, 45, 268–280.

Council on Communications and Media. (2009). Impact of music, music lyrics, and music videos on children and youth. Pediatrics, 124, 1488– 1494.

Council on Communications and Media. (2010). Media education. Pediatrics, 126, 1012–1017.

Cowley, G., & Underwood, A. (2001, February 19). Soda pop that packs a punch: Are the new alcoholic lemonades aimed at kids? Newsweek, p. 45.

Cruz, M. L., & Deyton, L. R. (2010). A new regulatory challenge: Youth and tobacco. Pediatrics, 125, 1066–1067.

Cullen, J., Sokol, N. A., Slawek, D., Allen, J. A., Vallone, D., & Healton, C. (2011). Depictions of tobacco use in 2007 broadcast television programming popular among US youth. Archives of Pediatrics and Adolescent Medicine, 165, 147–151.

Cumberbatch, G., & Gauntlett, S. (2005). Smoking, alcohol and drugs on television: A content analysis. Retrieved from

Currie, C., Hurrelmann, K., Settertobulte, W., Smith, R., & Todd, J. (2000). Health behaviour in school-aged children: A WHO cross-national Study. Copenhagen, Denmark: Authors.

Dalton, M. A., Adachi-Mejia, A. M., Longacre, M. R., Gibson, J. J., Martin, S. K., Sargent, J. D., & Beach, M. L. (2006). Parental rules and monitoring of children’s movie viewing associated with children’s risk for smoking and drinking. Pediatrics, 118, 1932–1942.

Dalton, M. A., Ahrens, M. B., Sargent, J. D., Mott, L. A., Beach, M. L., Tickle, J. J., & Heatherton, T. F. (2002). Correlation between use of tobacco and alcohol in adolescents and parental restrictions on movies. Effective Clinical Practice, 1, 1–10.

Dalton, M. A., Beach, M. L., Adachi-Mejia, A. M., Longacre, M. R., Matzkin, A. L., Sargent, J.D., . . . Titus-Ernstoff, L. (2009). Early exposure to movie smoking predicts established smoking by older teens


and young adults. Pediatrics, 123, e551–e558. Dalton, M. A., Sargent, J. D., Beach., M. L., Titus-Ernstoff, L., Gibson, J. J.,

Ahrens, M. B., . . . Heatherton, T. F. (2003). Effect of viewing smoking in movies on adolescent smoking initiation: A cohort study. Lancet, 362, 281–285.

Davis, R. M., Gilpin, E. A., Loken, B., Viswanath, K., Wakefield, M. A. (Eds.). (2008). The role of the media in promoting and reducing tobacco use (National Cancer Institute Tobacco Control Monograph Series, No. 19, Pub No. 07-6242). Retrieved from

de Leeuw, R. N. H., Sargent, J. D., Stoolmiller, M., Scholte, R. H. J., Engels, R. C. M. E., & Tanski, S. E. (2011). Association of smoking onset with R-rated movie restrictions and adolescent sensation seeking. Pediatrics, 127, e96–e105.

Desmond, R., & Carveth, R. (2007). The effects of advertising on children and adolescents: A meta-analysis. In R. W. Preiss, B. M. Gayle, N. Burrell, M. Allen, & J. Bryant (Eds.), Mass media effects research: Advances through meta-analysis (pp. 169–179). Mahwah, NJ: Lawrence Erlbaum.

DiFranza, J. R., Richards, J. W., Paulman, P. M., Wolf-Gillespie, N., Fletcher, C., Jaffe, R. D., & Murray, D. (1991). RJR Nabisco’s cartoon camel promotes Camel cigarettes to children. Journal of the American Medical Association, 266, 3149–3153.

DiFranza, J. R., Wellman, R. J., Sargent, J. D., Weitzman, M., Hipple, B. J., & Winickoff, J. P. (2006). Tobacco promotion and the initiation of tobacco use: Assessing the evidence for causality. Pediatrics, 117, e1237–e1248.

Donohue, J. M., Cevasco, M., & Rosenthal, M. B. (2007). A decade of direct-to-consumer advertising of prescription drugs. New England Journal of Medicine, 357, 673–681.

Dozier, D. M., Lauzen, M. M., Day, C. A., Payne, S. M., & Tafoya, M. R. (2005). Leaders and elites: Portrayals of smoking in popular films. Tobacco Control, 14, 7–9.

Duke, J. C., Allen, J. A., Pederson, L. L., Mowery, P. D., Xiao, H., & Sargent, J. D. (2009). Reported exposure to pro-tobacco messages in the media: Trends among youth in the United States, 2000–2004. American Journal of Health Promotion, 23, 195–202.

DuRant, R. H., Rome, E. S., Rich, M., Allred, E., Emans, S. J., & Woods, E.


R. (1997). Tobacco and alcohol use behaviors portrayed in music videos: A content analysis. American Journal of Public Health, 87, 1131–1135.

Edwards, C. A., Harris, W. C., Cook, D. R., Bedford, K. F., & Zuo, Y. (2004). Out of the smokescreen: Does an anti-smoking advertisement affect young women’s perception of smoking in movies and their intention to smoke? Tobacco Control, 13, 277–282.

Edwards, C., Oakes, W., & Bull, D. (2007). Out of the smokescreen II: Will an advertisement targeting the tobacco industry affect young people’s perception of smoking in movies and their intention to smoke? Tobacco Control, 16, 177–181.

Elliott, S. (2004). Viagra and the battle of the awkward ads. New York Times. Retrieved from the-awkward-ads.html?pagewanted=all

Engels, R. C. M. E., Herman, R., van Baaren, R. B., Hollenstein, T., & Bot, S. M. (2009). Alcohol portrayal on television affects actual drinking behaviour. Alcohol and Alcoholism, 44, 244–249.

Eslick, G. D., & Eslick, M. G. (2009). Smoking and The Simpsons. Medical Journal of Australia, 190, 637–639.

Eszterhas, J. (2004). Hollywood animal. New York, NY: Knopf. Farrelly, M. C., Davis, K. C., Haviland, M. L., Messeri, P., & Healton, C.

G. (2005). Evidence of a dose-response relationship between “truth” antismoking ads and youth smoking prevalence. American Journal of Public Health, 95, 425–431.

Federal Trade Commission. (1999). Self-regulation in the alcohol industry: A review of industry efforts to avoid promoting alcohol to underage consumers. Washington, DC: Author.

Federal Trade Commission. (2011). Federal Trade Commission cigarette report for 2007 and 2008. Retrieved from

Fischer, P. M., Schwartz, M. P., Richards, J. W., Goldstein, A. O., & Rojas, T. H. (1991). Brand logo recognition by children aged 3 to 6 years: Mickey Mouse and Old Joe the Camel. Journal of the American Medical Association, 266, 3145–3153.

Fisher, L. B., Miles, I. W., Austin, S. B., Camargo, C. A., Jr., & Colditz, G. A. (2007). Predictors of initiation of alcohol use among US adolescents: Findings from a prospective cohort study. Archives of Pediatrics and Adolescent Medicine, 161, 959–966.


Flynn, B. S., Worden, J. K., Bunn, J. Y., Dorwaldt, A. L., Connolly, S. W., & Ashikaga, T. (2007). Youth audience segmentation strategies for smoking- prevention mass media campaigns based on message appeal. Health Education and Behavior, 34, 578–593.

Forsyth, S. R., & Malone, R. E. (2010). “I’ll be your cigarette—light me up and get on with it”: Examining smoking imagery on YouTube. Nicotine and Tobacco Research, 12, 810–816.

Foster, S. E., Vaughan, R. D., Foster, W. H., & Califano, J. A., Jr. (2003). Alcohol consumption and expenditures for underage drinking and adult excessive drinking. Journal of the American Medical Association, 289, 989–995.

Foster, S. E., Vaughan, R. D., Foster, W. H., & Califano, J. A. Jr. (2006). Estimate of the commercial value of underage drinking and adult abusive and dependent drinking to the alcohol industry. Archives of Pediatrics and Adolescent Medicine, 160, 473–478.

Freeman, B., & Chapman, S. (2010). British American Tobacco on Facebook: Undermining Article 13 of the global World Health Organization Framework Convention on Tobacco Control. Tobacco Control, 19, e1–e9.

Fritschler, A. L., & Hoefler, J. M. (2006). Smoking & politics: Policy making and the federal bureaucracy (6th ed.). Upper Saddle River, NJ: Prentice Hall.

Frosch, D. L., Grande D., Tarn, D. M., & Kravitz, R. L. (2010). A decade of controversy: Balancing policy with evidence in the regulation of prescription drug advertising. American Journal of Public Health, 100, 24–32.

Frosch, D. L., Krueger, P. M., Hornik, R. C., Cronholm, P. F., & Barg, F. K. (2007). Creating a demand for prescription drugs: A content analysis of television direct-to-consumer advertising. Annals of Family Medicine, 5, 6–13.

Garfield, C. F., Chung, P. J., & Rathouz, P. J. (2003). Alcohol advertising in magazines and adolescent readership. Journal of the American Medical Association, 289, 2424–2429.

Gellad, Z. F., & Lyles, K. W. (2007). Direct-to-consumer advertising of pharmaceuticals. American Journal of Medicine, 120, 475–480.

Gidwani, P. P., Sobol, A., DeJong, W., Perrin, J. M., & Gortmaker, S. L. (2002). Television viewing and initiation of smoking among youth. Pediatrics, 110, 505–508.


Giedd, J. N. (2008). The teen brain: Insights from neuroimaging. Journal of Adolescent Health, 42, 335–343.

Gilpin, E. A., White, M. M., Messer, K., & Pierce, J. P. (2007). Receptivity to tobacco advertising and promotions among young adolescents as a predictor of established smoking in young adulthood. American Journal of Public Health, 97, 1489–1495.

Glantz, S. A., Iaccopucci, A., Titus, K., & Polansky, J. R. (2012). Smoking in top-grossing US movies, 2011. Preventing Chronic Disease, 9, 120170. Retrieved from

Glantz, S. A., Slade, J., Bero, L. A., & Hanauer, P. (1998). The cigarette papers. Berkeley: University of California Press.

Goldstein, A. O., Sobel, R. A., & Newman, G. R. (1999). Tobacco and alcohol use in G-rated children’s animated films. Journal of the American Medical Association, 281, 1131–1136.

Gomstyn, A. (2009, November 12). Buying cigarettes and quit-smoking aids from the same company? ABC News. Retrieved from

Gordon, R., MacKintosh, A. M., & Moodie, C. (2010). The impact of alcohol marketing on youth drinking behavior: A two-stage cohort study. Alcohol and Alcoholism, 45, 470–480.

Gostin, L. O. (2009). FDA regulation of tobacco: Politics, law, and the public’s health. Journal of the American Medical Association, 302, 1459–1460.

Greenberg, B. S., Rampoldi-Hnilo, L., & Mastro, D. (2000). The alphabet soup of television program ratings. Cresskill, NJ: Hampton Press.

Greenberg, B. S., Rosaen, S. F., Worrell, T. R., Salmon, C. T., & Volkman, J. E. (2009). A portrait of food and drink in commercial TV series. Health Communication, 24, 295–303.

Greenfield, T. K., & Rogers, J. D. (1999). Who drinks most of the alcohol in the U.S.? The policy implications. Journal of Studies on Alcohol and Drugs, 60, 78–89.

Grenard, J. L., Dent, C. W., & Stacy, A. W. (2013). Exposure to alcohol advertisements and teenage alcohol-related problems. Pediatrics, 131, e369–e379.

Grube, J. W., & Waiters, E. (2005). Alcohol in the media: Content and effects on drinking beliefs and behaviors among youth. Adolescent Medicine: State of the Art Reviews, 16, 327–343.


Gruber, E. L., Thau, H. M., Hill, D. L., Fisher, D. A., & Grube, J. W. (2005). Alcohol, tobacco and illicit substances in music videos: A content analysis of prevalence and genre. Journal of Adolescent Health, 37, 81–83.

Gruber, E. L., Wang, P. H., Christensen, J. S., Grube, J. W., & Fisher, D. A. (2005). Private television viewing, parental supervision, and sexual and substance use risk behaviors in adolescents [Abstract]. Journal of Adolescent Health, 36, 107.

Gunter, B., Oates, C., & Blades, M. (2004). Advertising to children on TV. Oxford, UK: Routledge.

Gutschoven, K., & Van den Bulck, J. (2004). Television viewing and smoking volume in adolescent smokers: A cross-sectional study. Preventive Medicine, 39, 1093–1098.

Halperin, S. (2008, April 18). Going to pot. Entertainment Weekly, pp. 38– 41.

Halpern-Felsher, B. L., & Cornell, J. L. (2005). Preventing underage alcohol use: Where do we go from here? Journal of Adolescent Health, 37, 1–3.

Hancox, R. J., Milne, B. J., & Poulton, R. (2004). Association between child and adolescent television viewing and adult health: A longitudinal birth cohort study. Lancet, 364, 257–262.

Hanewinkel, R. (2009). Cigarette smoking and perception of a movie character in a film trailer. Archives of Pediatrics and Adolescent Medicine, 163, 15–18.

Hanewinkel, R., Isensee, B., Sargent, J. D., & Morgenstern, M. (2010). Cigarette advertising and adolescent smoking. American Journal of Preventive Medicine, 38, 359–366.

Hanewinkel, R., Isensee, B., Sargent, J. D., & Morgenstern, M. (2011). Cigarette advertising and teen smoking initiation. Pediatrics, 127, e271– e278.

Hanewinkel, R., & Sargent, J. D. (2007). Exposure to smoking in popular contemporary movies and youth smoking in Germany. American Journal of Preventive Medicine, 32, 466–473.

Hanewinkel, R., & Sargent, J. D. (2009). Longitudinal study of exposure to entertainment media and alcohol use among German adolescents. Pediatrics, 123, 989–995.

Hanewinkel, R., Sargent, J. D., Karlsdottir, S., Jonsson, S. H., Mathis, F., Faggiano, F., . . . Morgenstern, M. (2012). High youth access to movies


that contain smoking in Europe compared with the USA. Tobacco Control. doi:10.1136/tobaccocontrol-2011-050050

Hanewinkel, R., Sargent, J. D., Poelen, E. A. P., Scholte, R., Florek, E., Sweeting, H., . . . Morgenstern, M. (2012). Alcohol consumption in movies and binge drinking in 6 European countries. Pediatrics, 129, 1– 12.

Harris, D. (2005, November 2). Is big tobacco sweet-talking kids into smoking? ABC News. Retrieved from

Hawkins, K., & Hane, A. C. (2000). Adolescents’ perceptions of print cigarette advertising: a case for counteradvertising. Journal of Health Communication, 5, 83–96.

Healton, C. G., Watson-Stryker, E. S., & Allen, J. A. (2006). Televised movie trainers: Undermining restrictions on advertising tobacco to youth. Archives of Pediatrics and Adolescent Medicine, 160, 885–888.

Heatherton, T. F., & Sargent, J. D. (2009). Does watching smoking in movies promote teenage smoking? Current Directions in Psychological Science, 18, 63–67.

Heavey, S., & Richwine, L. (2010, September 3). Special report: Outgunned FDA tries to get tough with drug ads. Reuters. Retrieved from idUSTRE6821PN20100903

Henriksen, L., Dauphinee, A. L., Wang, Y., & Fortmann, S. P. (2006). Industry sponsored anti-smoking ads and adolescent reactance: Test of a boomerang effect. Tobacco Control, 15, 13–18.

Henriksen, L., Feighery, E. C., Schleicher, N. C., & Fortmann, S. P. (2008). Receptivity to alcohol marketing predicts initiation of alcohol use. Journal of Adolescent Health, 42, 28–35.

Herd, D. (2008). Changes in drug use prevalence in rap music songs, 1979– 1997. Addiction Research and Theory, 16, 167–180.

Hill, A. B. (1965). The environment and disease: Association or causality? Proceedings of the Royal Society of Medicine, 58, 295–300.

Hingson, R. W., Heeren, T., & Winter, M. R. (2006). Age at drinking onset and alcohol dependence. Archives of Pediatrics and Adolescent Medicine, 160, 739–747.

Hingson, R. W., & Zha, W. (2009). Age of drinking onset, alcohol use disorders, frequent heavy drinking, and unintentionally injuring oneself and others after drinking. Pediatrics, 123, 1477–1484.


Hitti, M. (2006, August 11). Teens buying alcohol online. WebMD Medical News. Retrieved from online

Hogan, M. J., & Strasburger, V. C. (2008). Media and prosocial behavior in children and adolescents. In L. Nucci & D. Narvaez (Eds.), Handbook of moral and character education (pp. 537–553). Mahwah, NJ: Lawrence Erlbaum.

Hornik, R., Jacobsohn, L., Orwin, R., Piesse, A. N., & Kalton, G. (2008). Effects of the National Youth Anti-Drug Media Campaign on youths. American Journal of Public Health, 98, 2229–2236.

Hunt, K., Henderson, M., Wight, D., & Sargent, J. D. (2011). Exposure to smoking in films and own smoking among Scottish adolescents: A cross- sectional study. Thorax, 66, 866–874.

Ibrahim, J. K., & Glantz, S. A. (2007). The rise and fall of tobacco control media campaigns, 1967–2006. American Journal of Public Health, 97, 1383–1396.

Jackson, C., Brown J. D., & L’Engle, K. L. (2007). R-rated movies, bedroom televisions, and initiation of smoking by White and Black adolescents. Archives of Pediatrics and Adolescent Medicine, 161, 260– 268.

Jackson, D. Z. (1998, November 23). Big tobacco’s chump change. Liberal Opinion Week, p. 23.

Jamieson, P. E., & Romer, D. (2010). Trends in US movie tobacco portrayal since 1950: A historical analysis. Tobacco Control. Retrieved from q=w_tobaccocontrol_ahead_tab

Jenssen, B. P., Klein, J. D., Salazar, L. R., Daluge, N. A., & DiClemente, R. J. (2009). Exposure to tobacco on the Internet: Content analysis of adolescents’ Internet use. Pediatrics, 124, e180–e186.

Jernigan, D. H. (2006). Importance of reducing youth exposure to alcohol advertising. Archives of Pediatrics and Adolescent Medicine, 160, 100– 102.

Jernigan, D. H. (2009). Alcohol-branded merchandise: The need for action. Archives of Pediatrics and Adolescent Medicine, 163, 278–279.

Jernigan, D. H., Ostroff, J., & Ross, C. (2005). Alcohol advertising and youth: A measured approach. Journal of Public Health Policy, 26, 312– 325.


Jernigan, D. H., Ostroff, J., Ross, C., & O’Hara, J. A. (2004). Sex differences in adolescent exposure to alcohol advertising in magazines. Archives of Pediatrics and Adolescent Medicine, 158, 629–634.

Johnston, L. D., O’Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (2013). Monitoring the Future national results on adolescent drug use: Overview of key findings, 2012. Ann Arbor: Institute for Social Research, The University of Michigan.

Join Together Staff. (2011, April 29). 24 attorneys general ask FTC to do more to keep alcohol advertising from teens. Partnership at Retrieved from together/alcohol/24-attorneys-general-ask-ftc-to-do-more-to-keep- alcohol-advertising-from-teens

Journal Wire Reports. (2001, March 15). Advertising rose after tobacco suits. Albuquerque Journal, p. A4.

Kaiser Family Foundation. (2004). Entertainment education and health in the United States. Menlo Park, CA: Author.

Keeping, J. (2011, September 12). University of Michigan poll: Parents in the dark about teens’ marijuana, alcohol use. Retrieved from parents-in-the-dark-about-teens-marijuana-alcohol-use/

Kessler, D. (2001). A question of intent: A great American battle with a deadly industry. New York, NY: PublicAffairs.

Kilbourne, J. (1993). Killing us softly: Gender roles in advertising. Adolescent Medicine: State of the Art Reviews, 4, 635–649.

King, C., III, Siegel, M., Jernigan, D. H., Wulach, L., Ross, C., Dixon, K., & Ostroff, J. (2009). Adolescent exposure to alcohol advertising in magazines: An evaluation of advertising placement in relation to underage youth readership. Journal of Adolescent Health, 45, 626–633.

Kulig, J. W., & Committee on Substance Abuse. (2005). Tobacco, alcohol, and other drugs: The role of the pediatrician in prevention, identification, and management of substance abuse. Pediatrics, 115, 816–821.

Kulig, K., Brener, N. D., & McManus, T. (2003). Sexual activity and substance use among adolescents by category of physical activity plus team sports participation. Archives of Pediatrics and Adolescent Medicine, 157, 905–912.

Kunkel, D. (2007). Inching forward on tobacco advertising restrictions to prevent youth smoking. Archives of Pediatrics and Adolescent Medicine, 161, 515–516.


Kupersmidt, J. B., Scull, T. M., & Austin, E. W. (2010). Media literacy education for elementary school substance use prevention: Study of Media Detective. Pediatrics, 126, 525–531.

Kurtz, M. E., Kurtz, J. C., Johnson, S. M., & Cooper, W. (2001). Sources of information on the health effects of environmental tobacco smoke among African-American children and adolescents. Journal of Adolescent Health, 28, 458–464.

Landman, A., Ling, P. M., & Glantz, S. A. (2002). Tobacco industry youth smoking prevention programs: Protecting the industry and hurting tobacco control. American Journal of Public Health, 92, 917–930.

Langleben, D. D., Loughead, J. W., Ruparel, K., Hakun, J. G., Busch- Winokur, S., Holloway, M.B., . . . Lerman, C. (2009). Reduced prefrontal and temporal processing and recall of high ”sensation value” ads. NeuroImage, 46, 219–225.

Laugesen, M., & Meads, C. (1991). Tobacco advertising restrictions, price, income and tobacco consumption in OECD countries, 1960–1986. British Journal of Addiction, 86, 1343–1354.

Lilienfeld, S. O. (2007). Psychological treatments that cause harm. Perspectives on Psychological Science, 2, 53–70.

Litt, D. M., & Stock, M. L. (2011). Adolescent alcohol-related risk cognitions: The roles of social norms and social networking sites. Psychology of Addictive Behaviors, 25, 708–713.

Lochbuehler, K., Sargent, J. D., Scholte, R. H. J., Pieters, S., & Engels, C. M. E. (2012). Influence of smoking cues in movies on children’s beliefs about smoking. Pediatrics, 130, 1–7.

Long, J. A., O’Connor, P. G., Gerbner, G., & Concato, J. (2002). Use of alcohol, illicit drugs, and tobacco among characters on prime-time television. Substance Abuse, 23, 95–103.

Longacre, M. R., Adachi-Mejia, A. M., Titus-Ernstoff, L., Gibson, J. J., Beach, M. L., & Dalton, M. A. (2009). Parental attitudes about cigarette smoking and alcohol use in the Motion Picture Association of America rating system. Archives of Pediatrics and Adolescent Medicine, 163, 218–224.

Lovato, C., Watts, A., & Stead, L. F. (2011). Impact of tobacco advertising and promotion on increasing adolescent smoking behaviours (No. CD003439). Cochrane Database System Reviews, 10.

Lynam, D. R., Milich, R., Zimmerman, R., Novak, S. P., Logan, T. K., Martin, C., . . . Clayton, R. (1999). Project DARE: No effects at 10-year


follow-up. Journal of Consulting and Clinical Psychology, 67, 590– 593.

McClure, A. C., Stoolmiller, M., Tanski, S. E., Worth, K. A., & Sargent, J. D. (2009). Alcohol-branded merchandise and its association with drinking attitudes and outcomes in US adolescents. Archives of Pediatrics and Adolescent Medicine,163, 211–217.

McGee, R., Ketchel, J., & Reeder, A. I. (2007). Alcohol imagery on New Zealand television. Substance Abuse Treatment, Prevention, and Policy. Retrieved from

McMahon, R. L. (1994). Diagnosis, assessment and treatment of externalizing problems in children: The role of longitudinal data. Journal of Consulting and Clinical Psychology, 62, 901–917.

McMillen, R. C., Tanski, S., Winickoff, J., & Valentine, N. (2007). Attitudes about smoking in the movies. Retrieved from

Mednick, S. C., Christakis, N. A., & Fowler, J. H. (2010). The spread of sleep loss influences drug use in adolescent social networks. PloS One, 5, e9775.

Miller, J. W., Naimi, T. S., Brewer, R. D., & Jones, S. E. (2007). Binge drinking and associated health risk behaviors among high school students. Pediatrics, 119, 76–85.

Montgomery, K. C., & Chester, J. (2009). Interactive food and beverage marketing: Targeting adolescents in the digital age. Journal of Adolescent Health, 45, S18–S29.

Moreno, M. A., Briner, L.