‘Fortnite’ may be a virtual game, but it’s having real-life, dangerous effects

Currently, Fortnite is all the rage among children and adolescents who play video games. But more and more we’re finding that it is having negative, sometime dangerous effects in their lives. The following article, by Beth Teitell and published in the Boston Globe gives more insight.

“They are not sleeping. They are not going to school. They are dropping out of social activities. A lot of kids have stopped playing sports so they can do this.”

Michael Rich, a pediatrician and director of the Clinic for Interactive Media and Internet Disorders at Boston Children’s Hospital, was talking about the impact “Fortnite: Battle Royale” — a cartoonish multiplayer shooter game — is having on kids, mainly boys, some still in grade school.

“We have one kid who destroyed the family car because he thought his parents had locked his device inside,” Rich said. “He took a hammer to the windshield.”

A year and a half since the game’s release, Rich’s account is just one of many that describe an obsession so intense that kids are seeing doctors and therapists to break the game’s grip, in some cases losing so much weight — because they refuse to stop playing to eat — that doctors initially think they’re wasting away from a physical disease.

The stress on families has become so severe that parents are going to couples’ counselors, fighting over who’s to blame for allowing “Fortnite” into the house in the first place and how to rein in a situation that’s grown out of control.

“One of the parents will get to the point of almost considering a divorce,” said Rich Domenico, a therapist with LiveWell Therapy Associates, in the Back Bay. “It’s similar to working with parents who have a child addicted to drugs.”

Parents worrying about kids spending too much time playing video games isn’t new. But a few significant factors have combined to make today’s games harder to stop playing. Better technology has made the games more interactive, more engaging, and more artistic, said Douglas Gentile, an Iowa State University psychology professor and coauthor of the book “Violent Video Game Effects on Children and Adolescents.” More insidious, game makers have taken a lesson from slot-machine designers and started employing a variable reward schedule, according to Ofir Turel, a professor of Information Systems and Decision Sciences at California State University Fullerton.

In the case of “Fortnite,” the psychological manipulation combines with the game’s flashy colors, its many potential plots, and the element of social interaction to stimulate the brain and train it to “crave” more, he e-mailed the Globe.

“Kids are especially vulnerable to this ‘variable-reward’ mechanism because their brains are still imbalanced,” he explained. “They have almost fully developed reward processing brain systems but their self-control systems are not yet fully developed.”

“Fortnite” has been likened to a cross between “Minecraft” and “The Hunger Games.” Some 200 million people have played, but if you’re not one of them, here’s how it works: One hundred competitors are dropped on an island, where they run around finding weapons and materials to build walls, ramps, and floors that can protect them from other players.

As the game progresses, the game field gets smaller, putting opponents in ever closer range. The last player — or players, if friends are playing as a team — wins.

“Fortnite” is free, but more than 68 percent of players make in-game purchases — like pickaxes, dance moves, and outfits to personalize their characters — and the average player who makes purchases has spent $84.67, according to a 2018 study by the financial services firm Lendedu.

Epic Games Inc., creator of “Fortnite,” did not respond to Globe e-mails.

As “Fortnite” scare stories proliferate — a British behavioral specialist likened it to heroin — many parents wonder if any child can get sucked in.

Rich, of Boston Children’s Hospital, said his clinic has yet to see a patient struggling with “Fortnite” who does not also have an underlying issue. “In fact, we are currently characterizing PIMU” — Problematic Interactive Media Use — “not as a diagnosis, but as a syndrome, a group of symptoms of diagnoses ranging from ADHD to anxiety, depression, or mood disorders that manifest themselves in the interactive media environment.”

One of the BCH clinic’s patients is a Brookline boy who secretly used his father’s credit cards to make thousands of dollars of in-game purchases.

“My sweet mama’s boy became angry and disrespectful,” said the boy’s mother, who spoke to the Globe on condition of anonymity to protect her family’s privacy.

The personality transformation came after the boy switched from a Brookline public school to a private school in sixth grade. A lonely new kid, he eventually managed to make friends through his growing prowess in “Fortnite.”

As the game’s pull escalated, he refused to do anything but play. He wouldn’t go outside. Wouldn’t go to sleepaway camp. Didn’t even want to go out for his own birthday dinner.

“We couldn’t get him to do activities,” his mother said. “It was a constant argument.”

Gaming can lead to weight gain, as kids spend hours sitting on the couch. But Tara McCarthy, a clinical nutritionist with Boston Children’s Hospital, is seeing boys who won’t take a moment away from “Fortnite” to eat.

In each case, the patients came to her after a doctor found unexpected weight loss and, concerned, ordered follow-up evaluations.

McCarthy interviewed the patients, and after hearing descriptions of long stretches with no food intake, she made her diagnosis: “Fortnite.”

Lynne Karlson, a general pediatrician at Floating Hospital for Children at Tufts Medical Center, who has heard about kids denied “Fortnite” kicking down doors, suggests parents limit playtime “before it becomes so all-encompassing.”

But that can be harder than it sounds.

Samuel Roth, a clinical psychologist in Newton, described a scenario that will sound familiar to many parents.

“The parents make a deal with the kids,” he said. “ ‘You can play for this long,’ and the kids are agreeable — they’re eager to start playing.

“Everyone nods their heads, and everyone feels good, until it come to the end of the playing time, and the child cannot abide by the agreement, and the parents feel immensely violated. It tears at the fabric of trust in the family.”

As for the Brookline boy who stole his dad’s credit cards to fund his gaming, he hit rock bottom on a family trip to New Hampshire, in the summer of 2018, when he refused to go boating. While the rest of the group was enjoying the lake, he tried to break into the family car with a hammer to get his electronic device.

The incident lead to an 11-day inpatient hospital stay, where he got therapy and quit “Fortnite” cold turkey.

Looking back, even he is baffled by the power the game held. “It’s hard for me to understand why I got to the point where I was playing it so much and what I’d do to be able to play,” he said.

Now, at 13, on the other side of “Fortnite,” he’s disturbed by what he sees around him. “The little kids on the school bus have gone from Pokeman cards to ‘Fortnite,’ ” he said. “They’re in third and fourth grades and that’s all they talk about.”

If you have a loved one struggling with video game addiction please contact Tamara Ancona, MA, LPC at (678) 297-0708 for an evaluation, and to discuss the best treatment options available.

Teen Sexting Laws

Teens and cell phones bring up an ever changing landscape of pitfalls parents are trying to help them avoid. One huge pitfall? Sexting. The latest question, answered by Screenagers in the article below, is about laws effecting sexting within the teen demographic. Please read below to find out how to help your teen understand sexting and it’s consequences better.

Teenagers are budding with sexual energy. Mix that with cell phones and it can be a complicated combination. According to a JAMA Pediatrics report from last April that analyzed 39 studies of just over 110,000 under 18-year-olds (the mean age was 15.16 years, but ages ranged from 11-17 years)— it was found that roughly 15% of teenagers send sexts and 28% receive them.

It is so important to have an open line of communication with preteens and teens about the issues around revealing photos and videos (yes, videos—some teens send short sexually explicit videos to one another). Today’s TTT is all about just the facts. In a pragmatic way, try sharing with your teens and preteens what the laws are in your state—and, starting with this example case can also be helpful.

In 2015, two 16-year-olds from North Carolina were arrested and charged with multiple felony counts of sexual exploitation of a minor under the state’s child pornography laws. Their crime? The boyfriend and girlfriend sent nude photos to each other via text. They were charged as adults, faced four to ten years in prison and would have to register as sex offenders if convicted. The kids agreed to plea bargains that reduced their charges to misdemeanors. Still, a very scary situation. The teens were doing what some sexually curious boyfriends and girlfriends do—the last thing they wanted was to get in trouble and to break a law.  

North Carolina does not have any sexting laws—in fact, half of states do not have sexting laws. If the couple had been in a state with sexting laws, such as Arizona, Florida or Arkansas, they would have most likely been charged with something such as a misdemeanor and given the chance to prove their intent was not criminal. Sexting legislation is designed to deter teens from sexting with consequences including education and less severe sentences.

Below the TTT weekly questions, I’ve included part of the Cyberbullying Research Center’s chart that shows sexting laws for each state across the country. Here are some questions to get you started:

  • Are you aware that it is against the law to send and receive nude pictures, even if they are from your significant other?  
  • If you were creating laws on this topic, how would you do it?
  • If you were to write a letter to a younger student, what advice would you give them about issues surrounding the taking and dissemination of revealing and suggestive photos and videos?

To read more about the texting laws in your state click here.

If you have a loved one struggling with appropriate communication please contact Tamara Ancona, MA, LPC at (678) 297-0708 for an evaluation, and to discuss the best treatment options available.

Children are ‘competing to become better self-harmers’

Self-harm is becoming more and more prevalent among children. As it does they are looking for different ways to harm themselves. Below is a study about the lengths children are willing to go to in order to self-harm.

Children as young as 12 are competing with each other to commit worsening acts of self-harm on websites, a groundbreaking study reveals. They described wanting to become “better self-harmers” and match horrific injuries they saw on Tumblr, one of the sites they chose because posts receive little scrutiny.

It is the first time researchers have been able to lift the lid on experience of such sites, after securing approval to interview young self-harmers.

It will fuel growing concern sparked by the death of Molly Russell, 14, who took her life after viewing self-harm images on Instagram.

This weekend, the Royal College of Paediatrics and Child Health (RCPCH) called for urgent action by social media firms to tackle self-harm and backed demands for an independent regulator.

Dr Max Davie, RCPCH officer for health promotion, said: “We know that self-harm rates are high and rising, particularly among young girls, and so seeing the rise of accounts promoting self-harm is very concerning.

“The combination of social media’s incentives to be noticed, and the lack of effective regulation, can be toxic and may be contributing to this rise.”

Ministers are to announce plans for new laws to regulate social media in the next month following a Telegraph campaign for a statutory duty of care.

The Cardiff University study found some young people only began self-harming because the internet provided a catalyst. Most, though, were already self-harming and went online “to make sense of their behaviors”.

What they experienced online, however, largely normalized their harming so that it became “a routine, everyday activity”, said the researchers. The children were also able to discover and share new practices and techniques.

“They became motivated to engage in further harm … the exposure to other individuals’ severe acts made them want to become better self-harmers,” the study reports.

One woman, aged 19, told researchers she was left feeling one small cut was “not nearly good enough”.

The researchers discovered a “sense of competition”. One woman, aged 23, said she chided herself when she saw images: “Why can’t I do it like that?”

Tumblr was cited as the favored site because it was easy to search and find images, enabled image sharing and was “not encumbered by the monitoring and intervention by other social media and microblogging sites”, said the study. Instagram also featured.

Dr Nina Jacob, who led the research, said: “The lack of scrutiny and moderation, where you can purportedly ‘do what the hell you like’, together with perceived anonymity, meant the site was considered more authentic than alternative platforms.”

One 19-year-old woman told researchers: “Kids as young as 12 can use it … and there’s a big self-harm community on there. I got sucked into it and it did sort of increase the intensity of my self-harm again.”

In the study approved by the university’s ethics committee, the researchers displayed ads on 42,000 Facebook accounts, before 21 self-harmers – 18 girls and 3 boys – aged 16 to 24 volunteered for in-depth interviews.

Three quarters were attracted to sites that provided self-harming images. One described them as “triggering a rush like an addictive high”.

Dr Jon Goldin, vice-chairman of the child and adolescent faculty at the Royal College of Psychiatrists, said: “When people look up the words ‘self harm’ they should be directed to helpful sites which offer guidance and support, not to images of people hurting themselves.”

Tumblr refused to say how many moderators it employed but said it had teams to quickly take down any material that violated its rules by glorifying self-harm, and worked with charities and mental health experts to provide advice that automatically popped up when people put in self-harm searches.

Victoria McCullough, Tumblr director of social impact and policy, said: “Research has shown that deletion of content posted by individuals struggling with mental health issues can have the unintended consequence of ostracizing them and preventing them from seeking out the support they need. Together with government and advocacy leaders, we’re working to develop innovative approaches that help those in need.”

If you, or a loved one is struggling with self harm, please contact Tamara Ancona, MA, LPC at (678) 297-0708 for an evaluation, and to discuss the best treatment options available.

Super Bowl Ads and Young Children

Did you and your family watch the Superbowl last night? Not everyone watches for the football – many people watch for the advertisements and the half time show. But, are the ads really kid-friendly (or the half time show for that matter)? The article below, written by the Children’s Screen Time Action Network, demonstrates that they just might not be, and what you as a parent can do about it.

It was January 1999 and the Falcons and the Broncos were playing in Super Bowl XXXIII when I had the moment. (Not the Janet Jackson moment, that came later.) But, the ‘my-kids-should-not-be-seeing-ads” moment. You could argue it was the moment that led me here to CCFC.

We were happily having a family gathering to watch the game. Drinks, friends, and pigs-in-a-blanket. Cut to an ad with Olympic distance runner, Suzy Hamilton, in her bathroom. As creepy music builds up the tension, she closes the mirrored door of her medicine cabinet to reveal a masked stalker with a chainsaw. Suzy runs away in Nike sneakers, which apparently allow her to outrun her would-be killer. The Nike ad asks “Why sport?” The answer: “You’ll live longer.” My 10 year-old daughter was terrorized. Heck, I was terrorized!

As in years past, this year’s ads promote alcohol and junk food. No surprise. At least two feature smart devices as characters in the ad. For instance, (spoiler alert) the Pringles device laments not having hands or a mouth to taste the nutrition-free snack. Even worse, they all promote materialism and excess. For kids to imagine life without advertising, they need to know what’s up with it. Here are a few suggestions to warm up for the big night.

  1. Use it as a media literacy lesson. When you are watching ads, explain to younger children that a big company paid a lot of money to change your mind and make you buy something. Remind older kids, “Who’s messing with your emotions here?”
  2. Explain that the people in ads are actors. They are not real people like you and me. They are getting paid to make you think so. They probably don’t even like that car, taco, or makeup.
  3. Speak up about your values. Are there gendered or sexualized images you find degrading? Does the ad glorify alcohol or encourage consumption of expensive products like smartphones? Is it just plain stupid? As my mother always said, “Ads insult our intelligence.” A kid version of this phrase might be, “You are way too smart for this ad.”
  4. Prepare yourself. Don’t be surprised or embarrassed. Think about what you’ll tell the kids.
  5. Create ad-break fun. Tell the kids that when the ads come on, we’re going to get food, add a piece to the football puzzle on the kitchen table, or check our score chart to see who is closest. Take bathroom breaks, get PJs on – anything that will take them out of the room during ads.

Gambling Among Teens

Gambling - teens
Gambling is now more common among teenagers than drinking, smoking or taking drugs, a report has found.

The Gambling Commission says that 450,000 children aged between 11 and 16, equivalent to one in every seven, are taking part in some form of gambling.

Researchers found children were increasingly making wagers with friends at school or gambling online at home. More than 70,000 teenagers are classed as problem gamblers, with 55,000 more at risk of becoming addicted.

Parents and teachers were urged to warn their children about the risks of gambling in the same way they would about smoking, drinking and taking drugs. But only one in five children said their parents had done so.

Tim Miller, the executive director of the Gambling Commission, said: “Parents must have this conversation as they would with other areas of risk. We see it in computer games, on social media, in apps – activities that have all the same behaviors [as gambling] but none of the warnings or protections.”

The survey found that 14 per cent of children aged 11-16 had spent their own money on gambling in the past week, up from 12 per cent in 2017. That compared with 13 per cent who drank alcohol, 4 per cent who smoked and 2 per cent who took drugs. Gambling was common on fruit machines, with most pupils who gambled saying they did so for pleasure and to win money. Four in 10 – equivalent to 1.3 million – said they had gambled in the past year.

Figures suggested children were increasingly being exposed to gambling online. Three in 10 said they had opened “loot boxes” in video games, which give players random rewards and have been compared to gambling. Just over one in 10 played free-to-play casino games online. The research will add to concerns about the influence of gambling advertising before the watershed during football games and online.

Two thirds of young people had seen gambling adverts on television, 59 per cent on social media and 53 per cent on other websites; 46 per cent had seen gambling sponsorship at sport venues.

Mr Miller said although protecting children from the harms of gambling was a priority, regulation alone could not address all the risks to young people. “The most common forms of gambling by children do not happen in gambling premises,” he said. “Some are bets between friends, some are unlawful gambling on machines in pubs. But all present risks. It is vital that all those with a part to play in protecting children and young people – parents, businesses and regulators – work together.”

If you, or a loved one is struggling with an addiction to gambling call Tamara Ancona, MA, LPC at (678) 297-0708 for an evaluation, and to discuss the best treatment options available.