Depending on who you ask, the name Dr. David Walsh can mean a number of different things. According to his online biography at National Institute for Media and the Family (NIMF)-- the non-profit organization he founded in 1996 -- he is an psychologist, an educator, a family therapist, an author, a public speaker, a husband, and a father of three. To the mass media, he is an outspoken, reliable source on game violence. To journalists like myself, he is a the head of a prominent media watchdog group which releases an annual report card grading the video game industry. To the disbarred Florida attorney Jack Thompson, he is a corrupt yet charming individual whose methods are insufficient to keep violent games out of kids' hands. And to GamePolitics, the blog that watches Walsh, Thompson and the mass media like a hawk, he was a stalwart critic of violent video games who made a rather large mistake in accepting $50,000 from the Entertainment Software Association earlier this year, and whose credibility as watchdog has been in question ever since.

In early December, we spoke to NIMF spokesperson Darin Broton about the organization's most recent report card, and came away somewhat satisfied; Broton pledged that the NIMF would not fail to continue their even-handed critique of the industry in years to come. But we realized then that not all of our readers would be satisfied with the words of a paid spokesman -- and subsequently obtained an interview with Dr. Walsh himself.

What follows, however, is not merely the doctor's attempt to defend his organization. That's because far more than how they are funded, GameCyte is interested in what the NIMF stands for -- and how, in the face of increased video game violence and the burgeoning issue of video game addiction, Dr. Walsh will use his position to advocate and critique games in the future. Read on to hear what Dr. Walsh really thinks of the current body of research, and how he suggests both industry and media alike should deal with these controversial issues.

The Controversy

As GameCyte reported earlier this month, the NIMF's annual report card has changed drastically this year -- to the point that when GamePolitics asked "Where Have All the Critics Gone?" they took the report card as part proof that the family-friendly organization had been co-opted by the game industry. "Not surprisingly," editor Dennis McCauley wrote, "NIMF's 2008 Annual Video Game Report Card was a valentine to the game biz."

Certainly, they took a number of suspicious steps this year. Where the NIMF had traditionally slammed the ESRB for a lack of transparency and an unwillingness to use their own Adults Only (AO) rating, this year the ratings board got high marks. Where they traditionally conducted a survey of retailers, this year they relied on government (Federal Trade Commission) data to do the job for them. And where they traditionally spent time calling out industry and retail for failing to educate parents, this year they eschewed politics in favor of parental responsibility instead.

But having read the organization's Annual Report Cards dating back to 1998, I can tell you that it's true that the NIMF has, as Dr. Walsh states below, been heading this direction for a few years now:

Well, first of all it's perhaps not as big a shift as you might think. If you go back over the last three report cards, 11, 12, and 13 you will notice that in every report card, for the last three years, as the industry has made changes we have have had parent involvement, parental supervision, parent grades.

We have been calling upon parents to exert greater supervision for three years. I'm not saying you have said this, but some commentators have said we have made a complete U-turn this year, and that's not really true; it is definitely a change in that we have focused more on it, but the decision was based on several things that have happened over the last three years. One is that in other report cards, we have called upon parents to exert greater supervision, and no one has basically paid attention to that. When I say no one, I mean the media did not pick up on that at all. The media picked up on other things that we were saying, and that's one factor.

It's also hard to argue that the ESRB hasn't made some huge leaps in the right direction:

The other factor is that the industry really has made significant changes, particularly in the last couple of years. As you know, we have been very very hard on, for example, the ESRB in recent years. We've been very, very hard on the retailers. And this year's results really show marked improvement. One of the things that happened is I had my first-ever invitation by the ESRB to come to their offices in New York, and hang out, and walk around, and actually see it in action. And that was in advance of the report card, and so I knew what was going on, but I was also aware that they really have made substantive changes. The new content descriptors in plain English; the significant effort that they're putting into educating parents, beyond what they've ever done before; and basically, I was able to ask any staff member that I bumped into any question that I wanted.

I think they were really trying to be transparent about exactly how the process worked... and I did, I stopped and had conversations with people in various parts of the ESRB organization.

Having monitored the new ESRB rating descriptors for over a month myself, I have to say that they're a tremendous step towards transparency -- not to mention useful, for those parents who don't know that anime is not necessarily for the kiddies.

Furthermore, it's hard to begrudge a non-profit organization with just over $2 million in annual revenue (PDF) the opportunity to use the results of a massive government study that covers the same ground many, many times better:

In past years we've done our own secret shopper survey. We don't have the financial resources the Federal Trade Commission has, and in past years our secret shopper survey -- we've been able to send secret shoppers into as many as sixty stores. Well, the Federal Trade Commission released their study this year in which they'd gone into literally hundreds and hundreds of stores, and found 80% compliance. We were not going to have the resources to do as good a job as they had done, and what that report showed was that the enforcement rate by the retailers was at an all-time high.

But I'd heard all of these excuses before. What Dr. Walsh said that really interested me was how the NIMF intends to monitor the industry in future. Previously, spokesman Darin Broton told GameCyte that since the organization has transitioned from addressing policy issues to helping parents, their communication about such matters might occur largely in private; but when I asked Dr. Walsh if the NIMF's role as watchdog was over, he told me that there's at least one issue that they intend to address publicly in months to come:

Absolutely, we will continue to monitor the industry. Just because we acknowledge the progress that they made this year doesn't mean that we won't do our job to pay attention. We highlighted an issue this year in the report card that the industry is very, very hesitant to address. That is the issue -- for lack of a better term -- of video game addiction. A lot of folks are saying that the reason we made this year's pivot is because we received some funding from the ESA foundation. You know, the report card, first of all, was well underway before we received word of that. I didn't even know that we had applied to an ESA foundation grant -- our development office did that because the guidelines were so right in the sweet spot of other things that we do.

If this year's report card was shaped by the fact that the industry had "given us money," then I wouldn't be talking about addiction, because they don't want to talk about that. So we will continue to focus on things that are of importance in terms of child health and development, and parent information.

And Walsh reassured me that one of my personal pet peeves, the ESRB's Adults-Only (AO) rating which somehow distinguishes between what is appropriate for 17- and 18-year-olds differently, will almost certainly continue to be a point of contention for the org. "I think it is a distinction that does not make sense, and it doesn't make sense to a lot of people," Walsh said.

Walsh summed up his opinion of the 2008 Report Card controversy thus:

I think from the perspective of the gaming community, if we're tough on the industry, we're out to lunch -- we're a bunch of idiots who don't know what we're talking about. If we acknowledge industry progress, then somehow we've been bought out. So I don't expect to get winning grades, because that's not our role. Our role is to provide information for parents, and that's what we do.

Video Game Addiction

Dr. Walsh didn't need to convince me that there is such a thing as video game addiction. I have friends and relatives who have fallen to World of Warcraft, and taking their symptoms into account, I suppose that I myself was once addicted to Diablo II. But recently, game addiction has surfaced in the mass media as potential explanation for some truly tragic behavior, and so I asked Dr. Walsh if he believes this phenomenon will truly be the next big controversy. His response in full:

Oh, I think it will be, but I think what we need to do is gather a bit of information. I think what's happening, not just here in the United States but in other countries as well, is that there's some percentage of gamers -- and no one quite knows what the percentage is, different surveys have put it at different percentages -- but for some percentage of gamers, it seems to become an obsession. Other things in their life get neglected, sometimes even their health gets neglected, their grades start to suffer, relationships start to suffer, and so it starts to bear all the behavioral hallmarks of an addition. And so I think that's why the term has emerged. Of course, the term itself is controversial, because there are some, particularly in academia, who say that addiction signifies something that has to do with a chemical change. A dependency to a chemical. But we do have other behaviors that are recognized as addictions, the most common example to bear would be gambling addiction.

There doesn't seem to be a lot of debate now, ten, fifteen years after the term was first introduced, that there are some people for whom gambling -- which is a behavior, not a substance -- literally takes over their lives. For some gamers, gaming seems to be something that starts to have a negative impact on their lives, and they don't seem to be able to stop it. Now, the reason I believe that it's going to become more and more of an issue is because the anecdotal reports are coming in at a greater frequency than ever before. I did my first public presentation on this at a conference a month ago, a conference sponsored by one of the leading chemical dependency treatment centers in the country, Hazeldon. It's the first time I've ever given a full presentation on the whole question of video game addiction, and based on the reaction of the two-hundred professionals from all over the country who were in that room, this is not an issue that's going to go away. In the question-and-answer period afterwards, therapists and counselors from all over the country were saying, "We're seeing this in our offices every week, more and more frequently," and so I think the frequency is definitely something that's getting people's attention.

I mentioned it to a group of researchers at the university of Minnesota, just in a casual conversation last spring, and an informal study group has evolved, and our challenge now is keeping the study group a manageable size -- because there are more and more researchers who want to be a part of this, and it is something that I think people are seeing.

I think it's an issue -- and I'll use that word -- that is going to get more and more attention. And of course, so little reasearch has been done on it -- we need to figure out what the heck it is that we're talking about. (laughs) People see the behaviors, and so people in counseling offices, parents and spouses, are seeing the behaviors; but as happens with all issues like this, it's going to take a certain amount of time for people to say, "You know, this is something that we need to take seriously and therefore we need to find out something about it. Because as you know, there's been very very little research that's been done.

Any kind of compulsive behavior that gets on the radar screen goes through a certain history, and this one is following that history. And the first part of the history is denial. That was true of alcoholism. If you turn back the clock fifty years, alcoholism was not a disease -- alcoholism was a moral defect. And alcoholics were bums. That's why Alcoholics Anonymous -- the word "anonymous" -- was a very important part of that movement, because back in the 1950s, in the middle part of the last century it was extremely shameful; it was a moral degeneracy. Now today, alcoholism is a bonafide mental disease. When casinos started to pop up around the country twenty years ago, on reservations and Indian gaming, gambling moved out of Las Vegas and Atlantic City, and with the problems people started to see they began to talk about gambling addiction. And of course, the reaction then was "Oh, come on, it's not an addition -- these people just need to learn how to control their gambling." Today, we acknowledge that there's a gambling addiction.

Where we will go with video games, compulsive video game playing, whatever the term is, where we will end up with that ten years from now, I'm not quite sure. But I think it is something we'll have to take seriously, and the people who just pooh-pooh it and say there's nothing to it -- they haven't talked to the parents or the spouses that I've been talking to in the last couple of years.

But why games? Are they any more addictive than other media? Isn't it true, as the NIMF themselves suggested this year, that all media have the potential for addiction?

I think that there is some evidence that video games do have more of an addictive potential to them than other forms of media, and I think the reason is because it's interactive. When I'm watching a movie or a television program, I can certainly get engrossed in that, there's no question about that, and if I get really wrapped up in a good movie, the two hours of the movie can go by in a -- it seems like the blink of an eye -- but I think the very nature of video games as interactive, where I become involved in not just viewing the action but directing the action, I think make it a different psychological experience. I think part of the popularity of video games is that they are engaging -- that's why people like them so much, is because they are enjoyable, and engrossing. For the majority of game players, it's an enjoyable, engaging, engrossing activity. For some people -- and once again, we don't know what exactly's going on, we don't know how big the percentage is -- for some people, it appears that that very interactive and engaging element for them becomes something that's very difficult to control.

Of course, when sex and violence in video games became an issue, the content producers -- not the individuals affected -- become the target. Does Walsh expect Blizzard Entertainment, whose Wrath of the Lich King expansion just pushed WoW over 11.5 million subscribers, to experience a consumer backlash?

What my hope is is that there's not a backlash against anyone. What my hope is is that there's a recognition that for some people, this is a problem, and we have to figure out A.) how to prevent it from happening in the first place, or B.) for those for whom it does become a problem, figure out how to help them effectively. I would not hope that, just as I don't want to condemn an alcohol industry because some people become alcoholics, just as I don't want to close down all the casinos because there are some people who become compulsive gamblers, I would hope that we wouldn't go after companies that produce video games because for some people it becomes a problem.

But not all are so open-minded towards these vices, no?

I think a lot of that has to do with the reaction of the industry itself. In other words, I don't think that people condemn Anheuser-Busch because they brew and sell beer. And part of it is that alcohol companies have acknowledged that the use of their product can cause problems. I think it is smart of them to produce the whole "Drink Responsibly" programs and all of the things that they do. The acknowledgment that "Yes, there are some people for who our product is not a good match." Some people make the analogy with the tobacco industry, and I think there are two significant differences. Difference number one is that there is really no legitimate benefit from the use of tobacco. There's no health-producing positive effect. Second, the tobacco industry did everything they could to deny that there were any problems. With video games, there are all sorts of positive uses and applications of the product... and I think that it would be wise for the industry to acknowledge that for some people, there could be a problem, and for them to actually become part of the solution.

When I asked if Dr. Walsh and the NIMF would use their connections to suggest that Blizzard and co. do just that, he had a very intriguing answer for me: "Will we be doing that? I would say yes. We've had some conversations already along those lines, and I would say at this point -- and I'm not going to name names -- we're not getting a positive reception. But that may change as we go forward."

See, if I'm correct -- and of course, I think I'm correct (laughs) -- that the problem is not going to go away, and there's really a problem there, if the problem keeps growing then the outliers will get more attention. The kid who shoots his parents because they won't let him play the video game. That is such an outlier -- a one in a one-hundred-million case -- but as the problem grows, the outliers will grow, and the media will pay more and more attention to that. And as the media pay more and more attention to that, it will get more and more attention of policy leaders and folks in public health. Just as governments responded in South Korea, China and Japan...

This got on my radar screen because of my involvement with the government of South Korea. It was my first trip to South Korea, and I was invited to represent the United States at an internet safety conference. I did not go to that conference with video game addiction on my mind. But when I got there, that was one of the hottest topics at the conference, and the government was already involved, and so I sat down at lunch and I can't remember the titles of all of these people, but the National Youth Commission of South Korea, they wanted to know what we were seeing in the United States. "What are you doing in the United States?" and as it became more of an issue in South Korea, then the government got involved. As it became more of an issue in China, then the government got involved. Now, because we have a different form of government, we're not going to respond the same way the Chinese did, by taking kids out of homes and putting them in boot camps for six months -- we're not going to have any kind of response like that, but as it becomes more of a problem you can bet that there will be policy leaders who will be involved.

Will we have hearings on this in five years? I wouldn't be surprised.

Video Game Violence

Though the next public outcry over gaming may involve addiction, the effects of violent video games on children are debated to this day -- the state of California in particular home to one Senator Leland Yee who fervently believes that such titles should not be sold to minors. With Dr. Walsh on the phone, it was hard to resist asking him some questions about game violence as well.

Does Dr. Walsh truly believe that violent video games can provoke aggression in children? "Yes." Why? That required a slightly longer answer:

I think the research on media's impact on children is a very, very rich body of research. The bulk of that research is not on video games -- the bulk has been on television, simply because it's been around for so long. But there's a great deal of research showing that media has an impact on kids. There's actually a lot of research that shows that media has an impact on all of us, but our focus is kids. Now, every study, no matter what field you're talking about, is an imperfect study. And that's true whether you're talking about cancer, whether you're talking about heart disease, whether you're talking about video game violence. And so a lot of the critics of the research will point to various studies and if it's a laboratory research study, an experimental study like the type that Craig Anderson does, then you get the criticism that "this is such an unnatural situation, you can't extrapolate anything from that." Then, if you do real-world studies, the criticism is that "There could be this, that and the other variable that you didn't control for," which you can control in an experimental setting, but then...

So every study has its flaws, but as you know there's a statistical procedure where you can actually take a look at a body of research when it gets big enough, and that's called metaanalysis. And that literally calculates the probability that a body of research is incorrect. So you take these flawed studies, all of these imperfect studies, but enough of them point in the same direction, you can calculate "Well, what's the probability that they're all wrong?" The video game research field now is rich enough to do those metaanalytical studies, and the results of those studies show that indeed, these games do affect kids.

But it's the nature of the effect that I think is important to pay attention to. The common thing people say is, "I played video games, and I'm not violent." Well, of course! That's not the way risk factors work. That's the same as the person who says "Well, I eat McDonald's, and I don't have a heart condition." And I think the risk factor interpretation is the one we should be using. What I think we know from the research is that video game violence is a risk factor for aggression for kids, the same way that a high-fat diet is a risk factor for heart disease. Now, if the only risk factor I've got is a high-fat diet, then my risk for heart disease is pretty low, but if I drink a lot, high-fat diet, I'm obese, I don't get any exercise, after a while you're going to start to say, "Dave, you're a walking heart attack" -- because I have an accumulation of those risk factors. Because violent video games are a risk factor that we can do something about, we have a responsibility to do that, just as a parent has a responsibility to get their kid to eat a healthy diet.

I like the concept of violent games as a "risk factor" for aggression -- it's certainly a good bit better than the general assumption that violent games can have a direct effect on youth. Of course, when you're talking about statistical research, it's important to define what you mean when you say "aggression." Sure, violent video games can make kids aggressive, but does that aggression actually lead to violence itself?

There is some evidence that yes, it does. The operational definition of aggression does vary from study to study, so some studies have taken a look at aggressive thoughts, and the way kids look at the world -- aggressive attitudes. Other studies have actually taken a look at "Kids who play a lot of violent video games, do they get in more arguments with their teachers." I though the Doug Gentile study where teachers literally rated kids blindly, not knowing which kids were heavy video game users, and identified the kids in their classrooms as "more aggressive kids" which correlated with violent video game play was particularly interesting.

Now, all of those studies -- it's the body of studies that need to be taken, because the criticism of that study, which is a valid criticism, is "That may just mean that aggressive kids like to play violent video games. That doesn't mean the games are contributing to that." But there's another study that's been done that controls for that preexisting hostility. Every study has its flaws, and the people who don't do the research and just sit in their armchairs picking apart study after study saying "Therefore, we don't know anything," I don't think that's fair.

With Dr. Walsh absorbing every pointed criticism of violent game research in stride, I was running out of things to throw -- but remembered one last, important distinction that researchers often forget to take into account: frustration. Isn't it just as easy, if not easier, for a frustating game to provoke aggressive feelings in a subject than a violent one?

They've actually tried to tease out frustrating games and aggressive games, and "is there a difference," and the answer from some of those studies is "Yes, there is." You're right, that's a very, very good point: a difficult game can lead to frustration, which leads to aggression, and so the issue we'd really be looking at is whether challenging games are the issue; but researchers have tried to answer that question and it seems that it's the violence and the aggression.

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