Volume 44, Issue 3, Pages 203-205 (March 2009)

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Why Do Adolescent Health Researchers Ignore the Impact of the Media?

Article Outline

Imagine publishing a study on lung cancer and not assessing the smoking status of the patients; or publishing a review article on coronary artery disease and not mentioning the importance of lipid levels.

Recently, this Journal published a study on the antecedents of adolescent drug use [1]. No mention was made of the impact of the media. If this were a one-time occurrence, I could understand. But it is not. A comprehensive review of adolescent drug use in a different pediatric journal did the exact same thing several years ago [2]. The media probably influence virtually every aspect of adolescent risky behavior that practitioners and parents are worried about—sex, drugs, aggressive behavior, obesity, eating disorders, suicide, school performance—yet research articles and review articles about any of these problems fail to mention it (including a recent position paper from our own Society on adolescent obesity) [3], [4], [5], [6], [7]. International researchers are not immune to this problem either: a recent study to “evaluate the association of psychological, biological, social, and family characteristics” of teens with eating disorders symptomatology examined 2036 Portuguese adolescents; but not only did the authors not ask about media use, they never even mention the possibility that the media could be affecting teens' body self-image [8]. Even the highly respected Youth Risk Behavior Survey only recently added a mere two questions about media use—2 questions out of 89. The media may represent one of the single most important influences on adolescent attitudes and behavior that we know of, yet many researchers seem to be routinely ignoring its impact [3]. Why?

The apology that most researchers would offer is that their experimental model or their questionnaire did not allow for media influence. For example, in a recent Journal article, Cleveland et al. [1] used a Social Developmental Model (SDM) and a survey that does not seem to acknowledge media influence. “The SDM proposes that children learn patterns of behavior from socializing agents in four contexts: parents, peers, schools, and community” (p. 158). That sounds like a statement that could have been written in 1940, not 2008. Media have been accepted as being a major socializing influence since the U.S. Senate held hearings on media violence in 1954!

Perhaps there are other possibilities for this omission: researchers may simply not accept that there is a connection between media and any particular adolescent behavior. A well-known Toronto critic has been disputing the media violence research for decades, for example, despite the existence of more than 1000 research studies that attest to a connection between media violence and aggressive behavior [9], [10]. Social science research is difficult research—it is not like medical research. Trying to tease out media effects is like trying to study the effect of the air we breathe. A correlation coefficient of 0.3 in media research may be equivalent to a 0.8 in medical research [11]. Media are everywhere, and nearly every teenager spends an inordinate amount of time with them— an average of 6hours a day, according to the most recent study [12]. Surely that amount of time should give researchers pause when they are considering “socializing agents.”

Researchers, like parents and primary care providers, may simply be “clueless” about media effects [13]. Or they may remember a gentler, kinder media when they were growing up. Or adding a media component might increase their already-limited budgets. Or they may lack the expertise to design a media component to their research. If the latter is true, there are several members of the Society for Adolescent Medicine who are experts in the field and would be willing to give advice: Dina Borzekowski, Alison Field, Michael Rich, even moi (notice the sly media reference to Miss Piggy).

The evidence that media contribute to adolescent behavior is substantial, and can no longer be ignored. Here is what every adolescent health researcher and practitioner needs to know about media effects:

•Violence. The research on media violence and its relationship to real-life aggression is clear: young people learn their attitudes about violence at a very young age, and once learned, those attitudes are difficult to change [14], [15]. Conservative estimates are that media violence may be causing 10% of real-life violence—not the leading cause by any means, but an unhealthy chunk that we could do something about if we chose to [10], [11]. In addition, new research shows that just a minute or two of office counseling about media violence and guns could lead to less violence exposure for >800,000 children per year [16].

•Sex. There are now four longitudinal studies linking exposure to sexy media to earlier onset of sexual intercourse, and one that links early exposure to teenage pregnancy [17], [18], [19], [20], [21]. There are eight studies documenting that giving teenagers access to condoms does not lead to earlier sexual activity, yet the major networks continue to balk at airing condom advertisements [22], [23], [24], [25], [26], [27], [28], [29], [30].

•Drugs. New research shows that witnessing smoking scenes in movies may be the leading cause of smoking among teenagers [31], [32]. In addition, abundant research exists that attests to the impact of alcohol advertising and cigarette advertising on teenagers' use of those products [33].

•Obesity. Numerous international longitudinal studies show that media use is contributing to the current epidemic of obesity worldwide [34]. What is unclear is how: is it the 7500 food ads that children and teens see per year, most of which are for junk food or fast food [35]? Is it that watching television changes eating habits [36]? Or does media use displace more active physical pursuits [37]?

•Eating Disorders. Many young teen girls think they are fat when they are actually normal weight [38], and the media are a major contributor to the formation of a teen's body self-image [39]. A naturalistic study in Fiji found that the prevalence of eating disorders increased dramatically after the introduction of American TV programs [40].

•School Performance. Intensive media use may contribute to poor school performance and the development of attention deficit disorder [41], [42]. This research is currently in its infancy.

•Prosocial Effects. Despite all of the negative effects listed above, the media also can be powerfully prosocial [43]. Children and teens can learn antiviolence attitudes, empathy, tolerance toward people of other races and ethnicities, and respect for their elders [10], [43]. Yet Hollywood and society do not seem to want to use media in this way most of the time. Even schools have fallen behind the media revolution. How else can we explain continuing to force middle school students to read “Romeo and Juliet” as their first exposure to Shakespeare when (a) Shakespeare wrote his plays to be seen and performed, not to be read, and (b) there are at least 10 different versions available on DVD that the teens could watch?

Here's my advice: if you are a researcher and your model does not incorporate media questions, use a different model! Or add media questions of your own! The impact of media on adolescent behavior can no longer be ignored. Adolescent medicine practitioners need to ask two very simple questions of all teenagers they examine: (1) how much entertainment screen time do you spend per day? (2) Is there a TV set or Internet connection in your bedroom [44]? If you are a researcher attempting to study adolescent behavior, you must deal with the fact that the media have now become one of the leading “socializing agents” on adolescents today. The impact of media on adolescent behavior can simply no longer be ignored.

References

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Division of Adolescent Medicine, University of New Mexico School of Medicine, Albuquerque, New Mexico

PII: S1054-139X(08)00686-1

doi:10.1016/j.jadohealth.2008.12.019

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