Policy Statement—Impact of Music, Music Lyrics, and Music Videos on Children and Youth

Organizational Principles to Guide and Deﬁne the Child Health Care System and/or Improve the Health of all Children Policy Statement—Impact of Music, Music Lyrics, and Music Videos on Children and Youth

COUNCIL ON COMMUNICATIONS AND MEDIA abstract KEY WORDS Music plays an important role in the socialization of children and ado- music, lyrics, music videos, adolescents, violence lescents. Popular music is present almost everywhere, and it is easily This document is copyrighted and is property of the American Academy of Pediatrics and its Board of Directors. All authors available through the radio, various recordings, the Internet, and new have filed conflict of interest statements with the American technologies, allowing adolescents to hear it in diverse settings and Academy of Pediatrics. Any conflicts have been resolved through situations, alone or shared with friends. Parents often are unaware of a process approved by the Board of Directors. The American the lyrics to which their children are listening because of the increas- Academy of Pediatrics has neither solicited nor accepted any commercial involvement in the development of the content of ing use of downloaded music and headphones. Research on popular this publication. music has explored its effects on schoolwork, social interactions, mood and affect, and particularly behavior. The effect that popular music has on children’s and adolescents’ behavior and emotions is of paramount concern. Lyrics have become more explicit in their references to drugs, sex, and violence over the years, particularly in certain genres. A teenager’s preference for certain types of music could be correlated or associated with certain behaviors. As with popular music, the perception and the effect of music-video messages are important, because research has reported that exposure to violence, sexual messages, sexual stereotypes, and use of substances of abuse in mu- www.pediatrics.org/cgi/doi/10.1542/peds.2009-2145 sic videos might produce significant changes in behaviors and atti- doi:10.1542/peds.2009-2145 tudes of young viewers. Pediatricians and parents should be aware of All policy statements from the American Academy of Pediatrics this information. Furthermore, with the evidence portrayed in these automatically expire 5 years after publication unless reaffirmed, studies, it is essential for pediatricians and parents to take a stand revised, or retired at or before that time. regarding music lyrics. Pediatrics 2009;124:1488–1494 PEDIATRICS (ISSN Numbers: Print, 0031-4005; Online, 1098-4275). Copyright © 2009 by the American Academy of Pediatrics

INTRODUCTION Music plays an important role in the socialization of children and adolescents.1–3 Listening to popular music is considered by society to be a part of growing up.2 Music provides entertainment and distraction from problems and serves as a way to relieve tension and boredom. Some studies have reported that adolescents use popular music to deal with loneliness and to take control of their emotional status or mood.2,4 Music also can provide a background for romance and serve as the basis for establishing relationships in diverse settings.2 Adolescents use music in their process of identity formation,4–11 and their music preference provides them a means to achieve group identity and integration into the youth culture.5,7–9,12,13 Some authors have suggested that popular music provides adolescents with the means to resolve unconscious conﬂicts related to their particular developmental stage2,7,12,14 and that their music preference might reﬂect the level of turmoil of this stage.14–17 Adolescents’ choice of music and their reactions to and interpretations of it vary with age, culture, and ethnicity.2,13,14,18–25 Research has shown that

1488 AMERICAN ACADEMY OF PEDIATRICS Downloaded from www.aappublications.org/news by guest on September 23, 2021 FROM THE AMERICAN ACADEMY OF PEDIATRICS there also is a difference in these vari- with 100 fourth- through sixth-graders cuity, death, homicide, suicide, and ables between the genders.25 Female ad- revealed that 98% of these children lis- substance abuse.9,13,17,43,45,46–53 Most re- olescents are more likely than male ado- tened to popular music, 72% of them cently, some rap music has been char- lescents to use music to reflect their on “most days” or every day.30 Further- acterized by the presence of explicit emotional state, in particular when feel- more, it has been reported that children sexual language in its lyrics as well as ing lonely or “down.”2,26,27 Male adoles- 8 to 10 years of age listen to music an messages of violence, racism, homo- cents, on the other hand, are more likely average of 1 hour per day.25 With many phobia, and hatred toward wom- to use music as a stimulant, as a way to children and adolescents listening on en.9,10,42,54 Drug, tobacco, and alcohol “boost” their energy level, or to create a iPods or other devices using head- use also tend to be glorified in these more positive image of themselves.2,4,26 phones, parents may have little knowl- songs. To understand the importance of edge of what their children are listening In refuting concerns about the effect of music in the life of adolescents, a to. lyrics, some have argued that children survey performed in the early 1990s of Research on popular music has ex- and adolescents use music only for en- 2760 American adolescents aged 14 plored several areas such as its ef- tertainment, that little or no attention through 16 years revealed that they lis- fects on schoolwork,31 social interac- is paid to the words, and if any atten- tened to music an average of 40 hours tions, mood and affect,20,26,27,32,33 and tion is given, understanding tends to per week.28 In another study in 2000, particularly behavior.10,11,34–36 Several be limited and related to the experi- North et al4 found that a sample of 2465 theories have been developed to ex- ences lived by the listener.32,55 How- adolescents in England reported lis- plain the relationship between music ever, other studies have demonstrated tening to music for an average of 2.45 and behavior,15,37,38 and a number of the contrary.56 Approximately 17% of hours per day. On a study performed in studies have demonstrated that there male adolescents and 25% of female 2005 to assess media use of 8- to 18- is a relationship between music and adolescents expressed that they liked year-olds in the United States, Roberts emotions, regardless of age.20,23,27,39–41 their favorite songs specifically be- et al25 reported that on a given day, Although the emotional response to cause the lyrics were a reflection of 85% of 8- to 18-year-olds listen to mu- music depends on the way it is pre- their feelings.2 Also, it has been found sic. Although time devoted to listening sented, it is also true that it is closely that the more importance adolescents to music varies with age group, Amer- related to the age of the listener and give to a certain type of music, the ican youth listen to music from 1.5 to the experiences or preconceived more attention they will pay to the 2,55,57,58 2.5 hours per day. Still, a study per- ideas they bring to the music.2,14,39 lyrics. Furthermore, Knobloch- formed with a small sample of at-risk The effect that popular music has on Westerwick et al have stated that al- youth revealed an average of up to 6.8 children’s and adolescents’ behavior though young listeners might not un- hours of music-listening per day.29 Fur- and emotions is of paramount con- derstand all the details in lyrics, they thermore, Roberts et al found that 33% cern.40 There is particular concern recognize enough to obtain a general 11 of those listening to music did so while related to the lyrics of some genres idea of the message they bring. performing other tasks or activities. of music and their effect on children Regarding the effects of popular music These data support the idea that the and adolescents.3,10,11,42–45 on behavior, several studies have dem- prevalence of music-listening in ado- Lyrics have become more explicit in onstrated that preference for certain types of music could be correlated or lescents may be even higher than that their references to drugs, sex, and vio- associated with certain behaviors,* of television viewing. The reason for lence over the years.11 A content anal- such as the association of drug and this is that popular music is present ysis of the top 10 CDs performed by the alcohol use with “rave” music or elec- almost everywhere, from the super- National Institute on Media in 1999 re- tronic music dance events.13,50,51,62 Rob- market to the mall, often as back- vealed that each of these CDs included erts et al39 performed a study in 1997 ground music. It also is easily available at least 1 song with sexual content. at an adolescent clinic, and their re- through the radio, various recordings, Forty-two percent of the songs on 11,25 sults suggested that probably the best the Internet, and new technologies, these CDs contained very explicit sex- predictor of risk in adolescents re- allowing adolescents to hear it in di- ual content.46 Lyrics of some music lated to music is their self-report of verse settings and situations, alone or genres, such as rock, heavy metal, rap, negative feelings or emotions when lis- shared with friends. and new emerging genres such as reg- tening to any type of music. The au- Adolescents are not the only young gaeton, have been found to revolve consumers of popular music. A study around topics such as sexual promis- *Refs 2, 10, 17, 29, 37, 39, 42, and 59–65.

PEDIATRICS Volume 124, Number 5, November 2009 1489 Downloaded from www.aappublications.org/news by guest on September 23, 2021 thors of that study described an asso- formed in 1999 with a sample of 345 perception and the effect of music- ciation between negative emotional mothers from public schools revealed video messages on children and ado- response to music and risk-taking be- that 47% of the mothers believed that lescents is related to the age and de- haviors and even suggested that what violent messages in rap music contrib- velopmental and emotional stage of triggers risky behavior in some ado- ute to school violence70; yet, according the viewer, as well as the level of lescents is the negative emotional re- to a 2007 report from the Kaiser Family exposure. sponse rather than the type of music. Foundation on parents, children, and The prevalence of music-video– Scheel and Westefeld61 supported this the media,44 only 9% of parents re- watching has been studied in both the suggestion in 1999. Heavy metal and vealed being concerned about inap- United States and Europe.30,79,90,92,94 A some rock music have been associ- propriate content in music. study of 100 fourth- to sixth-graders ated in some studies with an increased The preference for heavy metal music, revealed that 75% of them watched risk of suicide.17,61,63,66,67 Fans of heavy rap, and associated genres among music videos, with 60% of them self- metal music have been reported in the adolescents must alert us to an in- describing their frequency of viewing literature to have more problems with creased vulnerability and tendency to- videos as either “pretty much” or “a school authorities and teachers than ward risky behaviors. Adolescents at lot.” Of these children, 62% watched students who are not fans of that type risk and with a feeling of alienation be- music videos either “most days” or “ev- of music.2 Heavy metal music-listening cause of previous failures or problems ery day,” and 7% watched them even has also been associated with in- tend to prefer these types of music, before going to school.30 In 2003, a re- creased depression, delinquency risk which might reflect their pessimistic port of the Kaiser Family Foundation90 behavior,63–65 smoking, and conduct view of life and the world.2,9,14,17,19,37,71 revealed that 3 of 4 of those in the 16- problems.60 Fans of heavy metal and Correlational studies, however, have to 24-year-old group watch MTV, 58% rap music showed a greater tendency inherent limitations and cannot iden- watch it at least once a week, and 20% to engage in reckless behavior than tify cause-and-effect relationships, but watch it for an hour or more every day. their peers who were not fans of those the associations reflect the status of More recently, a study revealed that a types of music.2,14,37,68 A study per- the current research. sample of 12- to 15-year-olds watched formed to explore the possible effect Research related to music and its ef- music videos on an average of 4.3 days of heavy metal music containing either fects on children and adolescents has per week.92 sexually violent or nonviolent lyrics on been expanded into another expres- Research on music videos has been fo- males’ attitudes toward women re- sion of popular music: the music video. cused mainly on content analyses. A vealed that those exposed to heavy Music videos are appealing to children study published in 1997 by DuRant et metal music, with either sexually vio- and adolescents. Considering that mu- al76,82 described an analysis of 518 mu- lent or nonviolent lyrics, showed sig- sic videos mix 2 media that are attrac- sic videos on 4 television networks nificantly more negative stereotyped tive to youth (television and popular (MTV, VH1, CMT, and BET). This study attitudes toward women than those in music), it is important to study their revealed that the percentage of vio- a group instead exposed to classical effects on a young audience and to lence in music videos ranged from 2,69 music. Likewise, in a study per- be concerned about the messages 11.5% to 22.4%, with the most violent 42 formed by Fischer and Greitemeyer, these music videos promote.30,72 Mu- videos having been presented on MTV. men who listened to misogynistic lyr- sic videos have been widely stud- When analyzed according to type of ics showed increased aggressive re- ied.29,30,55,72–93 They are mainly classified music, rap videos had the highest por- sponses toward women as well as a as either performance or concept vid- trayal of violence (20.4%), closely fol- more negative perception of them. eos. For a performance video, an artist lowed by rock videos (19.8%). Using In a study in which adolescents who or a group is filmed during a perfor- the same sample, another study re- preferred heavy metal and rap music mance, usually a concert. Concept vid- vealed that although the percentage of were compared with those who pre- eos, on the other hand, tell the viewer a videos that portrayed alcohol use ferred other types of music, results in- story that may or may not evolve from showed no significant differences dicated that the former consistently the song. This story may sometimes among networks, the percentage por- showed below-average current and el- add content to the lyrics and provide a trayed was still significant, ranging ementary school grades, with a history particular interpretation that is rein- from 18.7% to 26.9%. Of the networks, of counseling in elementary school for forced every time the viewer hears the MTV had the highest percentage of al- academic problems.14 A study per- song.72,73,75 As with popular music, the cohol representation and also the

1490 AMERICAN ACADEMY OF PEDIATRICS Downloaded from www.aappublications.org/news by guest on September 23, 2021 FROM THE AMERICAN ACADEMY OF PEDIATRICS highest percentage of videos that por- of seventh- and eighth-grade boys, issue. Therefore, the following recom- trayed smoking behaviors (25.7%). Of watching music videos and profes- mendations are made. these videos, rap music videos showed sional wrestling was associated with 1. Pediatricians should become fa- a higher content of alcohol or tobacco an increased acceptance of date rape. miliar with the role of music in the use than did other types of videos.75 In A survey performed among 214 adoles- lives of children and adolescents 1998, Rich et al82 reported on the find- cents revealed that there was an asso- and identify music preferences of ings of content analyses that looked for ciation between music-video–watching their patients as clues to emo- 76 gender or race differences in aggres- and permissive sexual behaviors. It tional conflict or problems.99 sors or victims of acts of violence por- has also been reported that after 2. Pediatricians should become fa- trayed in the same sample of 518 music watching MTV, adolescents’ attitudes miliar with the literature avail- videos. The analyses showed that black were more accepting of premarital able on the effects of music and individuals were overrepresented as ag- sex.52,53,80 A survey performed among music videos on children and gressors (25%) and as victims (41%), 2760 American adolescents demon- adolescents.36,38,100–103 compared with the percentage of black strated that listening to music and individuals in the general population watching television and music videos 3. Pediatricians should explore with (12%). Studies performed by Smith and more frequently was associated with patients and their parents what Boyson in 200293 and Gruber et al in increased risky behaviors68 and alco- types of music they listen to and 200591 validated these findings. hol use85,86; these results were vali- music videos they watch and un- Analysis of the content in music videos dated by van den Bulck and Beullens,94 der which circumstances they is important, because research has who demonstrated a longitudinal rela- consume these media. reported that exposure to violence, tionship between adolescents’ expo- 4. Pediatricians should encourage sexual messages, sexual stereotypes, sure to music videos and alcohol use parents to take an active role in and use of substances of abuse in mu- while going out to a bar, party, disco, monitoring the type of music to sic videos might produce significant etc. In 2003, Wingwood et al89 reported which their children and adoles- changes in behaviors and attitudes of on a study in which 522 black female cents are exposed and to be aware young viewers.† Frequent watching of adolescents with a median exposure to of the music they purchase.104–106 music videos has been related to an rap music videos of 14 hours per week Parents can find lyrics by typing increased risk of developing beliefs in were followed for 12 months. After “music lyrics” into an Internet false stereotypes and an increased controlling for all the covariates, search engine and accessing 1 or perceived importance of appearance greater exposure to rap music videos more of the Web sites that appear. and weight in adolescent girls.83 In was independently associated with a Pediatricians also should counsel studies performed to assess the reac- wide variety of risky behaviors such as parents and caregivers to monitor tions of young males exposed to violent increased promiscuity and use of and regulate television-viewing rap music videos or sexist videos, par- drugs and alcohol, among others. Of according to the age and maturity ticipants reported an increased prob- importance, a study performed by Aus- of their children and adolescents. tin et al98 in 2000 revealed that the po- ability that they would engage in vio- 5. Pediatricians should encourage tential risks of exposure to music vid- lence, a greater acceptance of the use parents and caregivers to become eos can be moderated by parental of violence, and a greater acceptance media literate. of the use of violence against women reinforcement and counterreinforce- 6. Pediatricians should sponsor and than did participants who were not ex- ment of conducts observed. participate in local and national posed to these videos.29,35,77,78,92 RECOMMENDATIONS coalitions to discuss the effects of In 1999 Kalof84 reported that college The American Academy of Pediatrics music on children and adoles- students who were exposed to videos understands that, given the findings cents to make the public and par- with stereotyped sexual images presented and our knowledge of child ents aware of sexually explicit, showed more acceptance of adver- and adolescent development, pediatri- drug-oriented, or violent lyrics on sarial relationships than those who cians and parents should be aware of CDs and cassettes, in music vid- were not exposed. Kaestle et al92 this information. Furthermore, with eos, on the Internet, and in emerg- reported in 2007 that in a group the evidence portrayed in these stud- ing technologies. †Refs 29, 35, 52, 53, 68, 72, 76–78, 80, 85, 89, 92 and ies, it is essential for pediatricians and 7. The public, and parents in particu- 94–97. parents to take a stand regarding this lar, should be aware of and use

PEDIATRICS Volume 124, Number 5, November 2009 1491 Downloaded from www.aappublications.org/news by guest on September 23, 2021 the music industry’s parental ad- stinence, pregnancy prevention, Holly L. Falik, MD visory warning of explicit content. and avoidance of promiscuity. Kathleen G. Nelson, MD Gwen S. O’Keefe, MD The advisory label is a black-and- 10. Further research on the effects of Victor C. Strasburger, MD white logo and should be located popular music, lyrics, and music FORMER EXECUTIVE COMMITTEE on the front of the CD, cassette, videos on children and adoles- MEMBERS album, videocassette, or DVD. It cents is important and should be *M. Rosario Gonza´lez de Rivas, MD may help protect children from conducted.107 Regina M. Milteer, MD certain offensive materials. Donald L. Shifrin, MD 8. Performers should serve as posi- COUNCIL ON COMMUNICATIONS AND LIAISONS tive role models for children and MEDIA EXECUTIVE COMMITTEE, Michael Brody, MD – American Academy of 2008–2009 Child and Adolescent Psychiatry teenagers. Brian Wilcox, PhD – American Psychological Gilbert L. Fuld, MD, Chairperson Association 9. The music-video industry should Deborah A. Mulligan, MD, Chairperson-Elect produce videos with more positive Tanya Remer Altmann, MD STAFF themes about relationships, racial Ari Brown, MD Veronica Laude Noland Dimitri Christakis, MD Gina Ley Steiner harmony, drug avoidance, nonvio- Kathleeen Clarke-Pearson, MD lent conﬂict resolution, sexual ab- Benard P. Dreyer, MD *Lead author REFERENCES

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