Even before its release on Nintendo Co.'s Wii and Sony Corp.'s PlayStation 2, Manhunt 2 is making waves across the world. Countries ban the game one after another, but it only seems to the hysteria.
The game depicts the escape of an amnesiac scientist and a psychotic killer from an asylum and their subsequent epic killing spree.
As more violent games become available for the Wii, the debate about their participatory nature is intensifying. Researchers who have been critical of first-person shooter games -- in which the player pushes a button to activate a weapon -- say the Wii's increased interactivity raises the risk of antisocial behavior.
In the United States the nation's Entertainment game has received the most restrictive rating possible, Adult Only, from the Software Rating Board. In Britain, the game is banned.
An AO rating, which is rare and typically applied for sexual content, means nobody under 18 can buy the game -- in which case many retailers, such as Wal-Mart and Best Buy, will probably not carry it. Rockstar, which is owned by Take-Two Interactive Software Inc., announced Thursday it is temporarily suspending the game's release, which was scheduled for July 10, because of the controversy. The company has 30 days to appeal the rating, accept it, or revamp the game and resubmit it for a new rating.
Rockstar had hoped for an M (mature) rating so the game could be sold to 17-year-olds. "This is a horror genre," Rockstar spokesman Rodney Walker said. "People who like horror will love it."
When the Wii hit the market, many people were excited about its possibilities. Teenagers would get up off the couch and exert themselves while playing. The game system has also been used in physical therapy and in retirement communities, where elderly residents are using it to play virtual golf and bowl. Now that the system has been out for a while, the violent games are emerging -- Scarface, Resident Evil 4, and Far Cry Vengeance, all rated M, are among the eight Wii games with violent content listed on the ESRB website.
"The more realistic and involving the game gets, and the greater the similarity between the action in the game and real life action, the stronger the negative effects would be," says Joanne Cantor, a Wisconsin research psychologist who has spent 30 years studying the effects of media violence on children. "No, your son may not turn into a criminal. But exposure will take a toll on his life somewhere, probably in interpersonal relationships. These are subtle effects. They take time to surface. A teen isn't going to notice them."
Child advocates such as the Boston-based Campaign for a Commercial - Free Childhood say violent games such as Manhunt 2 should be kept out of teenagers' hands. "I shudder to think of teenage boys playing this," says child psychiatrist Alvin Poussaint , director of the Media Center at the Judge Baker Children's Center, which houses the CCFC. "The level of participation makes the game worse than any that preceded it. It might not make anyone a killer, but could it make someone prone to domestic violence or child abuse?"
David Finkelhor , co director of the Family Research Lab at the University of New Hampshire, says no game alone is going to drag a child into criminal activity. "It's when you have other potentiating factors -- family problems, mental health issues, extreme stress, dangerous neighborhoods," he says. "Playing these games with or without the Wii enhancement is not going to take the typical teenage boy and make a killer out of him."
In fact, he says, in the 10 or 12 years in which violent video games have proliferated, the juvenile crime rate has gone down, as have school homicides.
Pediatrician Michael Rich , director of the Center on Media and Child Health at Children's Hospital, says there is a solid body of research to show that exposure to screen violence takes a toll. Teens risk becoming desensitized because their empathy skills and social restraints are not fully developed.
"Wii provides a double whammy," Rich says, "very violent content and physical involvement, which we know is how learning happens."
Not many sound that concerned. "Relative to Grand Theft Auto it's a lot less significant," Colin Sebastian, senior research analyst at Lazard Capital Markets. said of "Manhunt 2." "Grand Theft Auto is the key driver. This is a second-tier title."
The previous game in the series, "Grand Theft Auto: San Andreas," was at the center of a ratings controversy two years ago that sparked a Congressional inquiry.
Rockstar was forced to replace its first edition of "San Andreas" after a hacker discovered a password-protected game inside it that involved a sexual encounter.
It's not clear what effect the controversy had on sales, as the title had already been available for months by the time the hack was discovered. In 2004, the year it was released, "San Andreas" was the top seller with more than 5.1 million copies sold in the U.S., according to market analyst NPD Group.
A committee of the influential physicians' group has proposed video game addiction be listed as a mental disorder in the American Diagnostic and Statistic Manual of Mental Disorders, a guide used by the American Psychiatric Association in diagnosing mental illness.
Such a move would ease the path for insurance coverage of video game addiction.
But even before debate on the subject began, the committee that made the proposal backed away from its position, and instead recommended that the American Psychiatric Association consider the change when it revises its next diagnostic manual in 5 years.
The psychiatrist group has said if the science warrants, it could be considered for inclusion in the next diagnostic manual, which will be published in 2012.
While occasional use of video games is harmless and may even help with some disorders like autism, doctors said in extreme cases it can interfere with day-to-day necessities like working, showering or even eating.
"Working with this problem is no different than working with alcoholic patients. The same denial, the same rationalization, the same inability to give it up," Dr. Thomas Allen of the Osler Medical Center in Towson, Md.
Dr. Louis Kraus of the American Academy of Child and Adolescent Psychiatry and a psychiatrist at Rush University Medical Center, said it is not yet clear whether video games are addictive.
"It's not necessarily a cause-and-effect type issue. There may be certain kids who have a compulsive component to what they are doing," he said in an interview.
But addictive or not, too much time spent playing video games takes away from other important activities.
"The more time kids spend on video games, the less time they will have socializing, the less time they will have with their families, the less time they will have exercising," Kraus said. "They can make up academic deficits, but they can't make up the social ones."
The AMA committee will consider the testimony and make its final recommendation to the AMA's 555 voting delegates, who will vote on the matter later this week.
The Entertainment Software Association, which represents the $30 billion global video game industry, said more research is needed before video game addiction should be categorized as a mental disorder.