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Hey, it's Dr. Michael Rich, the mediatrician. I'm a practicing pediatrician, a child health researcher, and a lifelong filmmaker who understands how powerfully screens can engage and change us. As a doctor who takes care of kids every day, I see the struggles that many of them have with the screens that are all around them, from the smartphones in their pockets to the televisions on their walls to the computers in their schools. So what I'm trying to do is bring together my two worlds of media and child health and development to really understand how to raise healthy, happy, productive children in a world filled with digital screens. Mediatrix educator Christelle Lavallee joins me here each week to help address your questions.
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Yes, I do. Thanks, Michael. This question is coming to us from Nina, a mom in Westfield, New Jersey, who writes, is there a connection between excessive video game playing and increased anxiety levels? My son is 14 and has some basic anxieties like walking the dog at night that I feel are made worse by the first person shooter games he plays. I'd love to understand if you have seen any connections here. So, Michael, I like that Nina's question is asking how video games might be influencing her son's worldview. What does the research say that can help her understand what might be happening here?
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Both the research and my clinical experience bear out what Nina is seeing here in her son. I have had patients come to me who are having difficulty sleeping, who are having increased anxiety in different situations, and even one who, when walking at night with the dog, would not go near bushes because he was scared something would jump out and start shooting at him from behind the bushes.
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Oh, yikes.
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So what Nina can do is not assume that there's a relationship between the games her son plays and the anxiety he's experiencing, but to see what happens when he doesn't play them for a while to see if that anxiety is alleviated. Research supports what she's observing. In fact, numerous studies have found that children and adolescents frequently respond to media violence with increased fear and anxiety. And this is particularly in younger kids whose experience of the world is still limited and they're not as easily able to separate fiction from reality. So when they look at video games or even entertainment media such as television, they seem to inflate the apparent prevalence of violence in the world. It makes the world seem to be a mean and scary place. So we need to actually take a step back and say, are they learning about the world the way we want them to learn about the world? Are they learning how to behave in that world? The way we want them to, or should we modify the media they're exposed to so that they can be confident and kind of.
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Hmm, I like that. So, going back to Nina's question, she's right. It seems like there is a connection between her son's FPS or first person shooter gameplay and his fears about walking the dog at night. So how can we help her help her son to see that connection and help maybe reduce his gameplay and also reduce his fears?
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Well, I wouldn't jump to the conclusion that she's right. I would say test it. Test it with her son, sit down with her son and talk to him about it. And he will probably say, oh, it has no relationship.
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I'm sure he'll say that.
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Yeah, he loves the game, but say, let's try and let's see what happens. And there may be no relationship, but there may be a relationship and he may start to realize it. So instead of her sort of forcing it down his throat or saying the research or the mediatrician says this is a relationship and have her and him test it in their real lives and see what happens so he won't want to stop playing. But it's important for her also to say, I am concerned. I am observing this. You know, parents are still the most important connection kids have in their lives. Even those nonverbal adolescents who you think aren't paying any attention have a deep connectedness with their parents that they really listen. Sometimes they rebel against what they hear, but they really listen and they know how parents feel. So Nina should approach it not in a punishing or blaming way, but in a way that she's concerned and that she is worried for him. She's worried for his anxiety, his vulnerability, not for what he's doing. That's bad.
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I think that's great and so empowering. How can so say that there is a connection between his anxieties and his gameplay? What then?
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Well, then she can talk to him about whether he can control his anxiety without the game or with the game. In other words, first step is always awareness. If he is aware that the game is influencing his anxiety, he is able to stop it himself or modify it himself or at least be conscious of. Of the way he is being reflexively responding to these environments. So, you know, sometimes when kids realize these things for themselves, they correct it themselves. Because he doesn't want to be anxious. Right?
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Right. He wants to walk the dog.
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Exactly. Well, he may not want to walk the dog either, but you know, that's out of fear. That may be out of laziness, not out of anxiety. But what he really wants to do is be in control of his world as much as possible. And if he finds for himself that this is causing him to lose control in some way, he may modify that behavior all by himself.
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Wow. I think that's great. So, Nina, I hope this helps you with your conversation with your son, and thank you so much for writing in your wonderful question. For those of you out there who are interested in learning more, you can find all of our resources@askthemediatrician.org and you can connect to our Mediatrician on Twitter Mediatrician and submit your own question@askthemediatrician.org and finally, thank you so much for listening. Please make sure you share and subscribe
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to this podcast and enjoy your media and use them wisely. And enjoy your children and raise them wisely.
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Ask the Mediatrician is hosted by Dr. Michael Rich, joined by Mediatrix educator Christelle Lavallee. Jill R. Kavanaugh is our Chief Knowledge Officer. Original music composed by Christopher Cerf podcast and music recorded, mixed and edited at Saturn Sound Studios Executive Producer Alicia Haywood.
Release Date: December 24, 2019
Host(s): Dr. Michael Rich (The Mediatrician), Kristelle Lavallee
Main Theme: Understanding the connection between media use—especially video games—and anxiety in children and adolescents, practical guidance for parents navigating media’s impact on kids’ emotional health.
This episode addresses a parent’s concern about whether excessive video game play—especially first-person shooters—could be increasing her teenage son’s anxiety. Dr. Michael Rich (the Mediatrician) and his colleague Kristelle Lavallee discuss research evidence linking media violence to heightened anxiety, share clinical anecdotes, and provide actionable advice for families. The tone is empathetic, evidence-based, and empowering, emphasizing communication and curiosity over punishment.
[01:03–01:38]
[01:38–03:15]
Dr. Rich confirms both research and his clinic cases support the connection Nina observes.
Clinical example: Patients anxious about real-life situations after exposure to virtual violence (e.g., refusing to walk near bushes out of fear someone might “jump out and start shooting”).
Insight: Media—especially violent games—can make children see the world as a “mean and scary place,” inflating the perceived prevalence of violence.
Developmental Perspective: Younger kids, with limited real-world experience, struggle to distinguish fiction from reality, making them more vulnerable to anxiety influenced by media content.
"So when they look at video games or even entertainment media such as television, they seem to inflate the apparent prevalence of violence in the world. It makes the world seem to be a mean and scary place."
— Dr. Michael Rich [02:38]
[03:15–05:00]
Key Message: Don’t assume a cause-and-effect link; instead, test it with curiosity.
Dr. Rich suggests Nina talk openly with her son and propose an experiment: take a break from the games and observe changes in his anxiety.
Recommend this approach over confrontation or blame. Kids may resist at first but value parental concern.
Parent-Child Bond: Adolescents still care deeply about parental feelings, even if they appear indifferent or rebellious.
"Parents are still the most important connection kids have in their lives... Even those nonverbal adolescents who you think aren't paying any attention have a deep connectedness with their parents that they really listen.”
— Dr. Michael Rich [04:28]
[05:00–06:12]
If the “test” shows a link, awareness is the first step—helping the child recognize the impact of media on their feelings.
Empower children to make their own changes, rather than imposing restrictions—they’re more likely to self-regulate if they understand the effects.
The goal: Kids in control of their world, not ruled by unconscious anxieties fueled by games.
“If he finds for himself that this is causing him to lose control in some way, he may modify that behavior all by himself.”
— Dr. Michael Rich [05:49]
On researched links:
“Numerous studies have found that children and adolescents frequently respond to media violence with increased fear and anxiety.”
— Dr. Michael Rich [02:15]
On parental influence:
“Nina should approach it not in a punishing or blaming way, but in a way that she's concerned and that she is worried for him.”
— Dr. Michael Rich [04:46]
On empowering kids:
“First step is always awareness. If he is aware that the game is influencing his anxiety, he is able to stop it himself or modify it himself…”
— Dr. Michael Rich [05:14]
| Timestamp | Segment/Topic | |-----------|---------------------------------------------------------------------| | 01:03 | Listener Nina’s question about video games and anxiety | | 01:38 | Research: Media violence and youth anxiety | | 02:38 | Real-life clinical story: Fear from gaming crosses into real world | | 03:15 | Discussion on approaching child with curiosity, not assumptions | | 04:28 | The lasting power of the parent-child connection | | 05:00 | Guidance: “Test the connection,” empower child’s awareness | | 05:49 | Kids taking control of their own behaviors if they discover a link | | 06:12 | Wrap and encouragement for Nina and other parents |
For more:
Find resources and submit your own questions at askthemediatrician.org