See discussions, stats, and author profiles for this publication at: https://www.researchgate.net/publication/234085964 Reality Television Predicts Both Positive and Negative Outcomes for Adolescent Girls Article in The Journal of pediatrics · January 2013 DOI: 10.1016/j.jpeds.2012.11.067 · Source: PubMed CITATIONS READS 3 491 3 authors, including: Christopher J Ferguson Stetson University 157 PUBLICATIONS 4,069 CITATIONS SEE PROFILE All content following this page was uploaded by Christopher J Ferguson on 19 February 2014. The user has requested enhancement of the downloaded file. All in-text references underlined in blue are linked to publications on ResearchGate, letting you access and read them immediately. 1 2 3 4 Q8 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 Q3 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 Q4 59 60 61 ½T1Š 62 63 64 Reality Television Predicts Both Positive and Negative Outcomes for Adolescent Girls Christopher J. Ferguson, PhD1, Kimberlee Salmond, MPP2, and Kamla Modi, PhD2 Objective To assess the influence of media, specifically reality television, on adolescent behavior. Study design A total of 1141 preteen and adolescent girls (age range 11-17) answered questions related to their reality television viewing, personality, self-esteem, relational aggression, appearance focus, and desire for fame. Results Our results indicated that the influence of reality television on adolescent behavior is complex and potentially related to the adolescents’ intended uses and gratifications for using reality television. Reality television viewing was positively related to increased self-esteem and expectations of respect in dating relationships. However, watching reality television also was related to an increased focus on appearance and willingness to compromise other values for fame. Reality television viewing did not predict relational aggression. Conclusion The potential influences of reality television use on adolescent girls are both positive and negative, defying easy categorization. (J Pediatr 2013;-:---). eality television includes several subgenres, including talent competitions, dating shows, real-life shows, and makeover shows. During the past decade, reality television shows have regularly dominated the top 10 television show ratings.1 Nonetheless, research on reality television has been sparse. Some investigators have examined the issue of reality television viewing and appearance concerns. In one study, researchers found that watching cosmetic surgery programs increased disordered eating attitudes in women with pre-existing thin-ideal internalization but not other women.2 In another study an author considered the impact of cosmetic surgery focused reality programming and found that such shows had little impact on body image but did promote positive beliefs about the benefits of cosmetic surgery.3 The author concluded that the effects of such shows are probably not alarming but may have some subtle influences. Emerging adults are more likely to wish to alter their appearance through cosmetic surgery after having seen cosmetic surgery reality programming.4,5 Other research has suggested that reality television connectedness (ie, feeling as if one relates personally to the show content) correlates with a focus on one’s appearance (valuing physical appearance as a major facet of self-esteem), although did not relate to academic performance.5 Another study indicated that viewing reality dating shows predicted adversarial sexual attitudes, a focus on one’s appearance, and sexual double standards, but these correlations were mediated by viewer engagement.6 Negative outcomes were related more to viewers’ desires to learn from the shows and beliefs that they were entertaining and valuable rather than from direct exposure. Dating programs did not predict real-life sexual behaviors of viewers. Other research suggested that watching dating shows was related to discussions of sex among teens, but not their expectations for dating relationships.7 These results suggest that a uses and gratifications approach to understanding media use may best explain reality television viewing.8 Several recent studies have suggested the uses and gratifications approach is particularly useful in understanding the effects of reality television.9,10 Although results from previous studies are somewhat mixed, they suggest that reality programming may be related to an increased focus on one’s appearance. Less is known about other outcomes, such as relational aggression or self-esteem. Furthermore, most existing work has been done with emerging adults, and very little empirical work has examined the influence of reality television in adolescence. Given that the uses and gratifications approach suggests that the use of media is not passive but involves an interaction between the viewer and media, we sought to examine the interaction between adolescent personality and reality television viewing. The current study examines the correlational relationship between reality television viewing with self-esteem, focus on one’s appearance, relational aggression, expectations of respect in dating relationships, desire for fame, and willingness to sacrifice other values to become famous. R Methods Participants in the current study were 1141 adolescent girls (age range 11-17 years, M = 14.3, SD = 2.1) who participated in the Real to Me survey research project of the Girl Scout Research Institute (Table I). This article is the empirical reporting of those results and the only journal article in which we cite these data. Participants were recruited via an online survey, with the pool of participants matched to the US population of adolescents in regard to From the 1Texas A&M International University, Laredo, TX; and 2Girl Scout Research Institute Q1 The authors declare no conflicts of interest. Q2 0022-3476/$ - see front matter. Copyright ª 2013 Mosby Inc. All rights reserved. http://dx.doi.org/10.1016/j.jpeds.2012.11.067 1 FLA 5.1.0 DTD Š YMPD5831_proof Š 19 December 2012 Š 5:28 am Š ce 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 THE JOURNAL OF PEDIATRICS 132 133 134 135 136 137 138 139 140 141 142 143 144 145 146 147 148 149 150 151 152 153 154 155 156 157 158 159 160 161 162 163 164 165 166 167 168 169 170 171 172 173 174 175 176 177 178 179 180 181 182 183 184 185 186 187 188 189 190 191 192 193 194 195 196 197 198  www.jpeds.com Table I. Demographic information for the current sample Mean age, y Ethnicity, % White African American Asian American Hispanic Native American Other Mean hours watched of television per week 14.3 (SD = 2.1) 68.4 14.0 6.0 13.2 1.8 2.7 12.4 (SD = 11.7) geography, ethnicity, and urbanicity. This sample is nonrandom. Regarding ethnicity, 68.4% of girls identified as white American, 14% as African American, 6% as Asian American, 1.8% as Native American, 13.2% as Hispanic, and 2.7% as other. Girls were permitted to select more than one ethnic category, given the probability of girls from multiple ethnic backgrounds; thus, the numbers add to greater than 100%. All measures were created internally for the Real to Me project by the Girl Scout Research Institute. All items described below used Likert scale items unless indicated otherwise. All scales were developed by the Girl Scout Research Institute. The full survey is available on request to the authors. Reality Television Viewing Participants were asked to report their frequency of viewing each of the 4 main types of reality programming, namely, talent competition shows, dating shows, real-life programming, and makeover shows. A composite variable for total reality television viewing was calculated from these 4 items. Coefficient alpha for this composite measure was adequate at 0.70, suggesting general consistency in watching reality television across subgenres. We also assessed hours spent weekly watching television generally. Skepticism of Reality Television Increasingly, people are becoming aware that “reality” television often is scripted and not necessarily indicative of reality. The hypothesis that reality television will have impact on behavioral outcomes is particularly predicated on the concern such shows will be perceived by viewers as “real.”2 Thus, controlling for viewer skepticism regarding the “reality” of such shows is important. Six items were constructed for this purpose that inquired as to the perceived reality of reality television programming. Sample items include “Real-life based reality shows (eg, Jersey Shore, 16 and Pregnant, The Hills) are completely real and unscripted” and “The relationships portrayed between girls on reality shows are an accurate reflection of how it is in real life.” Coefficient alpha for the resulting scale was 0.72. Histrionic Personality Traits The uses and gratifications model of media use suggests that individual personality styles drive the use of media and lessons learned from it. In the case of reality television 2 Vol. -, No. programming, histrionic personality traits (attention-seeking, emotional shallowness) appeared particularly relevant. It may be that teens with histrionic traits are more likely to seek out reality television programming and may also be more likely to demonstrate negative outcomes (eg, focus on one’s appearance, relational aggression, fame seeking). Thus, controlling for these personality traits appeared important, and we used 3 items to tap into this construct related to attention seeking and emotional shallowness. Sample items include “I will do things that go against my personal values to get people to like me” and “Sometimes I act crazy to get attention.” Coefficient alpha of the resultant scale was 0.70. Self-Esteem Self-esteem was measured by the use of a 27-item scale that tapped into girls’ perceptions of themselves as positive and capable. Sample items include “I’m very happy with the person I am today” and “I see myself as a role model to other girls.” Coefficient alpha for this scale was 0.77. Focus on Appearance Focus on one’s appearance was measured with 3 forcedchoice items in which required girls to choose whether they would prefer to be recognized for their physical beauty or for their intelligence, inner beauty, or talent. Coefficient alpha was 0.64 for this scale. Relational Aggression Relational aggression was measured with a 12-item scale that tapped into issues such as gossiping, being mean to others, and lying to others to get ahead. Sample items include “Gossiping is a normal part of a relationship between girls” and “Sometimes you have to be mean to others to get what you want.” Coefficient alpha for this scale was 0.79. Expectations of Respect in Dating Relationships Girls’ expectations for having mutually respectful dating relationships were measured using a 3-item scale. Sample items include “How likely do you think it will be that you will have a healthy romantic relationship in the future” and “How likely do you think it will be that romantic partners will always treat you with respect.” Coefficient alpha for this scale was 0.74. Becoming Famous A single Likert scale item “How important is it for you to become famous in your future” was used to measure girls’ desire to become famous. Compromise for Fame Girl’s willingness to compromise other values in order to become famous was measured using a 12 item scale. Girls were asked how likely they would be to engage in a number of activities such as “pretend to be someone you’re not,” “wear sexy or revealing clothing,” “put down or mistreat someone else,” “getting pregnant on purpose,” and “drop out of school.” Coefficient alpha for this scale was 0.92. Ferguson, Salmond, and Modi FLA 5.1.0 DTD Š YMPD5831_proof Š 19 December 2012 Š 5:28 am Š ce 199 200 201 202 203 204 205 206 207 208 209 210 211 212 213 214 215 216 217 218 219 220 221 222 223 224 225 226 227 228 229 230 231 232 233 234 235 236 237 238 239 240 241 242 243 244 245 246 247 248 249 250 251 252 253 254 255 256 257 258 259 260 261 262 263 264 265 ORIGINAL ARTICLES - 2012 Data Analyses 266 The influence of reality television viewing, with age, ethnicity, 267 skepticism about reality television, and histrionic personality 268 controlled, on each of the outcome variables was tested via 269 the use of linear regression. Ethnicity was dummy-coded 270 for each category; thus, we compare all individuals of that 271 272 ethnicity with all other individuals. Multicollinearity was 273 not an issue for any of these analyses with the lowest tolerance 274 Q5 of 0.31 and the highest VIF of 3.22. The highest scores were 275 among the ethnic variables, specifically white American, Af276 rican American, and Hispanic, likely because of the option 277 278 for participants to select more than one of these categories. 279 Rerunning analyses without the ethnic variables did not 280 change the results for other predictor variables. Thus, we 281 are confident that multicollinearity issues were minimal. 282 283 284 285 286 Bivariate relationships between the predictor and outcome 287 288 ½T2Š measures are presented in Table II. To reduce type I error attributable to multiple comparisons, a Bonferroni 289 290 correction of 0.0011 was used for statistical significance. 291 Linear regression was used with age, ethnicity, skepticism of 292 reality television, and histrionic traits entered as predictors. 293 The resultant model was statistically significant (R = 0.41, 294 P = .001). Skepticism of reality television not surprisingly 295 296 predicted lower viewing (b = 0.38, 95% CI = 0.43, 297 0.33) and was by far the strongest predictor of reality 298 television viewing. Weaker predictors included age (b = 0.10, 299 95% CI = 0.04, 0.16) and histrionic traits (b = 0.07, 95% 300 CI = 0.01, 0.13) although these are perhaps too small to 301 302 warrant practical consideration.11 303 More descriptively, only 12.1% of girls reported watching 304 reality television shows “rarely or never” across all 4 sub305 genres. Per each subgenre, 77.3% of girls reported watching 306 reality talent competition shows “sometimes” or “regularly,” 307 308 as did 28.7% of girls for reality dating shows, 60.9% of girls for 309 “real-life” reality shows, and 58% of girls for makeover shows. 310 The regression model for self-esteem was statistically sig311 nificant (R = 0.25, P = .001). Reality television viewing was, 312 in fact, the only predictor of self esteem and was positively 313 314 correlated (b = 0.19, 95% CI = 0.13, 0.25) with a small effect 315 size. None of the other included study variables predicted 316 girls’ self-esteem. 317 318 319 320 Table II. Bivariate correlations between all predictor and 321 Measure 1 2 3 322 323 1. Reality television viewing 1.00 0.39* 0.15* 324 2. Reality television skepticism 1.00 0.24* 325 3. Histrionic personality traits 1.00 4. Self-esteem 326 5. Focus on one’s appearance 327 6. Relational aggression 328 7. Expectations of respect 329 8. Becoming famous 330 9. Compromise for fame 331 332 *P < .0011. Results The regression model for appearance focus was statistically significant (R = 0.37, P = .001). Focus on one’s appearance was significantly predicted by reality television viewing (b = 0.08, 95% CI = 0.02, 0.14), although this relationship was weak. Other predictors of appearance focus included age (b = 0.12, 95% CI = 0.06, 0.18), skepticism of reality television (b = 0.08, 95% CI = 0.02, 0.14) and histrionic traits (b = 0.29, 95% CI = 0.24, 0.34). With the exception of a moderately strong histrionic effect, most of these effects were weak in size. The regression model for relational aggression was statistically significant (R = 0.52, P = .001). Relational aggression was significantly predicted by age (b = 0.20, 95% CI = 0.14, 0.26), Asian ethnicity (b = 0.08, 95% CI = 0.02, 0.14), although this was only a weak effect, and histrionic traits (b = 0.46, 95% CI = 0.41, 0.50). Reality television viewing did not significantly predict relational aggression. Once again, histrionic traits demonstrate a moderately strong effect, with a small effect for age. The regression model for expecting respect in dating relationships was statistically significant (R = 0.17, P = .01). Expecting respect was significantly predicted by reality television viewing (b = 0.10, 95% CI = 0.04, 0.16), as well as histrionic traits (b = 0.12, 95% CI = 0.06, 0.18). Both of these effects are small in size. The regression model for desiring fame was statistically significant (R = 0.38, P = .001). Desiring fame was significantly predicted by age (b = 0.12, 95% CI = 0.06, 0.18), African-American ethnicity (b = 0.10, 95% CI = 0.04, 0.16), skepticism of reality television (b = 0.09, 95% CI = 0.03, 0.15), and histrionic traits (b = 0.27, 95% CI = 0.22, 0.32). Reality television viewing did not predict the desire to be famous. All effects were small in size with histrionic traits being the strongest of them. The regression model for willingness to compromise other values for fame was statistically significant (R = 0.52, P = .001). Willingness to compromise other values for fame was significantly predicted by reality television viewing (b = 0.11, 95% CI = 0.05, 0.17), age (b = 0.08, 95% CI = 0.02, 0.14), and histrionic traits (b = 0.50, 95% CI = 0.45, 0.54). The effect for histrionic traits is moderately strong, with effects for reality television viewing and age small to weak. All standardized regression coefficients are presented for all regressions in Table III. ½T3Š outcome measures in the current study 4 0.23* 0.14* 0.02 1.00 5 0.17* 0.16* 0.30* 0.01 1.00 6 0.16* 0.15* 0.45* 0.09 0.38* 1.00 Reality Television Predicts Both Positive and Negative Outcomes for Adolescent Girls FLA 5.1.0 DTD Š YMPD5831_proof Š 19 December 2012 Š 5:28 am Š ce 7 0.10 0.05 0.10* 0.23* 0.11* 0.27* 1.00 8 0.12* 0.21* 0.31* 0.19* 0.23* 0.22* 0.02 1.00 9 0.20* 0.14* 0.51* 0.04 0.39* 0.53* 0.16* 0.31* 1.00 3 333 334 335 336 337 338 339 340 341 342 343 344 345 346 347 348 349 350 351 352 353 354 355 356 357 358 359 360 361 362 363 364 365 366 367 368 369 370 371 372 373 374 375 376 377 378 379 380 381 382 383 384 385 386 387 388 389 390 391 392 393 394 395 396 397 398 399 THE JOURNAL OF PEDIATRICS 400 401 402 403 404 405 406 407 408 409 410 411 412 413 414 415 416 417 418 419 420 421 422 423 424 425 426 427 428 429 430 431 432 433 434 435 436 437 438 439 440 441 442 443 444 445 446 447 448 449 450 451 452 453 454 455 456 457 458 459 460 461 462 463 464 465 466  www.jpeds.com Vol. -, No. - Table III. Standardized regression coefficients for linear regression results for the association between reality television viewing and all outcome variables with other variables controlled Predictor variable Self-esteem Age 0.01 White 0.03 African American 0.06 Asian American 0.05 Native American 0.02 Hispanic 0.03 Skepticism of reality 0.05 television Histrionic traits 0.05 Reality television viewing 0.19 (0.13, 0.25)* Focus on one’s appearance Relational agg. 0.12 (0.06, 0.18)* 0.20 (0.14, 0.26)* 0.05 0.04 0.05 0.06 0.02 0.08 (0.02, 0.14)* 0.04 0.04 0.02 0.01 0.03 0.08 ( 0.02, 0.14)* 0.29 (0.24, 0.34)* 0.08 (0.02, 0.14)* 0.46 (0.41, 0.50)* 0.03 Expect respect 0.03 0.01 0.03 0.07 0.01 0.03 0.03 0.12 ( 0.06, 0.18)* 0.10 (0.04, 0.16)* Fame Comp 0.12 ( 0.06, 0.18)* 0.08 (0.02, 0.14)* 0.03 0.03 0.10 (0.04, 0.16)* 0.01 0.03 0.03 0.03 0.01 0.01 0.03 0.09 ( 0.03, 0.15)* 0.02 0.27 (0.22, 0.32)* 0.04 0.50 (0.46, 0.54)* 0.11 (0.05, 0.17)* Expect respect, expectations of respect; Fame, becoming famous; Comp, compromise for fame. *P < .05. Discussion On the positive side, reality television viewing was related to increased self-esteem as well as expectations of respect in dating relationships. However, reality television viewing was associated with increased appearance focus and willingness to compromise other values for fame. Reality television viewing was not related to relational aggression or the desire for future fame. We emphasize that these relationships were correlational in nature and we do not mean to imply causality. Within our sample, reality television watching correlated only r = 0.14 (although statistically significant) with general television use, suggesting that reality television consumption is a relatively distinct phenomenon and the relationships found here cannot be easily explained by more general television effects. Perhaps contrary to expectations, reality television viewing was not related to relational aggression. Recently, some scholars have posited that perhaps aggression is not so clearly learned through imitation as had previously been thought.12,13 Given that relational aggression has been found to be very common across reality television subgenres,1 the lack of correlation in the present study suggests that reality television relational aggression is not being modeled by viewers. The effect size in the regression was little different from zero (b = 0.03, 95% CI = 0.03, 0.09) suggesting that Type II error is unlikely. Some studies have suggested that aggression is more likely learned from peers or families, rather than media14 and that may be the case here as well. Unfortunately peer and family variables were not included in the present study. In the current study, histrionic traits were, by far, the strongest predictor of relational aggression, suggesting that aggression may be better viewed as internally motivated rather than externally cued. Even the outcome for focus on one’s appearance may not be as negative as we initially implied. For instance, this variable focuses on evaluations of beauty and their selfimportance, not necessarily disturbed body image, which would be of more clinical importance. Focus on one’s appearance and self-esteem were not correlated in our study 4 (r = 0.01), suggesting that a focus on one’s appearance is not necessarily related to harmful outcomes in young girls. Indeed, given that the adolescent years typically involve the onset of dating, focus on one’s appearance may represent reasonable concerns rather than an irrational misattribution of value. This is not to say that girls should not be encouraged from focusing on other aspects of their worth (eg, intelligence, talent, decision making) when evaluating themselves. Rather, the lack of correlation between appearance focus and self-esteem suggests girls may already be doing this. The relationship with willingness to compromise for fame is more clearly negative. Many of the choices some girls were willing to make to seek fame involved clearly unethical (lying, betraying others) or risky (getting pregnant on purpose as a teen) behaviors. To the extent that reality television viewing may be involved in teens’ willingness to take greater risks, this issue is worthy of further pursuit. Age was a consistent predictor among many of our outcomes. Older girls were more likely to watch television, have a greater focus on their appearance, engage in more relational aggression, and express more willingness to compromise for fame, although interestingly they desire fame less than younger girls. These age-related trends raise the possibility that interest in reality television may be part of a broader developmental shift in motivations and interest. If one uses the uses and gratifications approach, it may be that older girls are more interested in reality television because the relational aggression in those shows provides an outlet or means of identification with the relational aggression experienced in their actual lives. Naturally, more research would be welcome on this issue. In understanding these myriad relationships, it may help to approach media use from the perspective of uses and gratifications.8 This requires something of a shift from the traditional social science model of media use which has generally posited effects through direct imitation.12,13 The effects of media effects may be a more subtle and interactive process that involves interactions between viewers and media. For instance, throughout our analyses, the intrapsychic factor of histrionic personality traits was a far stronger predictor, Ferguson, Salmond, and Modi FLA 5.1.0 DTD Š YMPD5831_proof Š 19 December 2012 Š 5:28 am Š ce 467 468 469 470 471 472 473 474 475 476 477 478 479 480 481 482 483 484 485 486 487 488 489 490 491 492 493 494 495 496 497 498 499 500 501 502 503 504 505 506 507 508 509 510 511 512 513 514 515 516 517 518 519 520 521 522 523 524 525 526 527 528 529 530 531 532 533 ORIGINAL ARTICLES - 2012 534 535 536 537 538 539 540 541 542 543 544 545 546 547 548 549 550 551 552 553 554 555 556 557 558 559 560 561 562 563 564 565 566 567 568 569 570 571 572 573 574 575 576 577 578 579 580 581 582 583 584 585 586 587 588 589 590 591 592 593 594 595 596 597 598 599 600 particularly of negative outcomes, than was reality television viewing, although individuals higher in histrionic traits were more likely to seek out reality television programming. Whether girls do or do not understand the staged nature of much of reality programming, it may be that girls seek out this form of media to enhance their sense of self-esteem and expectations for dating relationships. In this sense, the relationships and conflicts viewed in reality programming may serve as a kind of mental dress rehearsal for girls’ own future relationships, as well as their sense of efficacy in handling such relationships. Given that reality shows tend to focus on the imperfections of their stars, seeing imperfections in others on television may help enhance girls’ sense of selfworth. The use of a uses and gratifications paradigm will involve a considerable shift in the way that media effects research is typically conducted. Most media effects approaches remain rooted in the belief that media is something done to viewers, particularly youth. However, the involvement of the viewer in the process may be far more active and effects far more subtle than proposed by traditional media effects theories. More research from the uses and gratifications perspective, examining how youth are active participants in media, rather than simply passive victims, would be of great value. We argue that this shift in theoretical paradigm, however, may lead to a more sophisticated understanding of the interaction of media such as reality television with young viewers. The current study has limitations. First, it is correlational in nature and, thus, causal inferences cannot be made from the current data. Further studies using prospective data would be helpful in delineating time sequencing of media use and outcome data. Experimental studies of reality television use would also be of value. The addition of such studies may assist with causal inferences. In addition our online sampling approach may have resulted in a sample that is weighted toward girls with relatively high technological savvy. Thus, our results should not be generalized to all teen girls. Second, the current study did not include important control variables, such as peer and family environment variables. Further research may wish to consider including controls for these influences. Third, although we assessed the focus on one’s appearance, we did not include measures of body dissatisfaction, which would have been a more clearly negative outcome. Further research should consider body dissatisfaction as a potential outcome. Finally, our results are for general reality television use. We did rerun our analyses on our 4 subcategories of reality television and found little difference in our results. However further research may wish to consider specific subcategories of reality television more closely for potential differences in effects. Trained raters could be used to examine show content of specific shows and examine these in relation to viewer behavior. On balance, our results suggest that the associations between reality television and behavioral outcomes for adolescent girls are complex and subtle. As noted by others,15 concerns about serious public health consequences of media use are quite common. However, at least for reality television viewing, we found little evidence that would lead us to conclude consuming such media rises to the level of a public health concern. Reality television viewing was associated with variable positive and negative outcomes, most of these small in terms of effect size. This fits well with research in other entertainment domains that suggests that the effects of media can be quite variable, as well as more complex and subtle than is sometimes thought.16 It may be that the psychological and behavioral health of teenage girls is less malleable than is sometimes thought. Or, it may be that reality television, for whatever reason, is not a primary conduit through which girls receive information on how they should behave. For instance, technology may be more likely to influence teens through means that allow youth to communicate directly, as with social media. It seems reasonable to suggest that media research would be well-served by focusing on uses and gratifications-based approaches to understanding media use. Such approaches emphasize the viewer as an active participant in selecting and interpreting media and differ somewhat from the traditional media effects paradigm, in which the viewer is implicitly assumed to be a passive vessel for media messages. The uses and gratifications approaches does not preclude the possibility that the media may influence viewers, however, and assumes such influences are more complex, subtle, and interactive than often portrayed in the traditional media effects model. Our data here add some preliminary support to this view. Using this theoretical approach suggests it is important for future research to consider the individual and the media choices he or she makes as a more central part of the process of media use and effects. Media use is likely driven by the internal needs and reactions of the individual viewer rather than something done to viewers by media. Given the popularity of reality television among the current generation of youth, investigating their relationship with behavioral outcomes among youth is an important avenue of study. n Submitted for publication May 7, 2012; last revision received Nov 9, 2012; accepted Nov 20, 2012. Reprint requests: Christopher J. Ferguson, PhD, Department of Psychology and Communication, Texas A&M International University, 5201 University Blvd., Laredo, TX 78041. E-mail: CJFerguson1111@aol.com References 1. Coyne S, Robinson S, Nelson D. Does reality backbite? Physical, verbal, and relational aggression in reality television programs. J Broadcasting Electronic Media 2010;54:282-98. 2. Mazzeo S, Trace S, Mitchell K, Gow R. Effects of a reality TV cosmetic surgery makeover program on eating disordered attitudes and behaviors. Eating Behav 2007;8:390-7. 3. Nabi R. Cosmetic surgery makeover programs and intentions to undergo cosmetic enhancements: a consideration of three models of media effects. Human Commun Res 2009;35:1-27. 4. Markey C, Markey P. A correlational and experimental examination of reality television viewing and interest in cosmetic surgery. Body Image 2010;7:165-71. 5. Markey C, Markey P. Emerging adults’ responses to a media presentation of idealized female beauty: an examination of cosmetic surgery in reality programming. Psychol Popular Culture Media, in press. Q6 Reality Television Predicts Both Positive and Negative Outcomes for Adolescent Girls FLA 5.1.0 DTD Š YMPD5831_proof Š 19 December 2012 Š 5:28 am Š ce 5 601 602 603 604 605 606 607 608 609 610 611 612 613 614 615 616 617 618 619 620 621 622 623 624 625 626 627 628 629 630 631 632 633 634 635 636 637 638 639 640 641 642 643 644 645 646 647 648 649 650 651 652 653 654 655 656 657 658 659 660 661 662 663 664 665 666 667 THE JOURNAL OF PEDIATRICS  www.jpeds.com 6. Zurbriggen E, Morgan E. Who wants to marry a millionaire? Reality Dating television programs, attitudes toward sex, and sexual behaviors. Sex 668 Roles 2006;54:1-17. 669 7. Vandenbosch L, Eggermont S. Temptation Island, the Bachelor, Joe Mil670 lionaire: a prospective cohort study on the role of romantically themed 671 reality television in adolescents’ sexual development. J Broadcasting 672 Electronic Media 2011;55:563-80. 673 8. Sherry J, Lucas K, Greenberg B, Lachlan K. Video game uses and gratifi674 cations as predicators of use and game preference. In: Vorderer P, 675 Bryant J, eds. Playing video games: motives, responses, and consequences. 676 Mahwah, NJ: Lawrence Erlbaum Associates Publishers; 2006. p. 213-24. 677 Q7 9. Papacharissi Z, Mendelson A. An exploratory study of reality appeal: 678 uses and gratifications of reality TV shows. J Broadcasting Electronic 679 Media 2007;51:355-70. 680 10. Nabi R, Stitt C, Halford J, Finnerty K. Emotional and cognitive predic681 tors of the enjoyment and reality-based and fictional television program682 683 684 685 686 687 688 689 690 691 692 693 694 695 696 697 698 699 700 701 702 703 704 705 706 707 708 709 710 711 712 713 714 715 716 717 718 719 720 721 722 723 724 725 726 727 728 729 730 731 732 733 734 6 Vol. -, No. - 11. 12. 13. 14. 15. 16. ming: an elaboration of the uses and gratifications perspective. Media Psychol 2006;8:421-47. Ferguson C. An effect size primer: a guide for clinicians and researchers. Professional Psychol 2009;40:532-8. Olson C. Children’s motivations for video game play in the context of normal development. Rev Gen Psychol 2010;14:180-7. Savage J, Yancey C. The effects of media violence exposure on criminal aggression: a meta-analysis. Crim Just Behav 2008;35:772-91. Ferguson C. Video games and youth violence: a prospective analysis in adolescents. J Youth Adolesc 2011;40:377-91. Barnett J, Coulson M. Virtually real: a psychological perspective on massively multiplayer online games. Rev Gen Psychol 2010;14: 167-9. Desai R, Krishnan-Sarin S, Cavallo D, Potenza M. Video-gaming among high school students: health correlates, gender differences, and problematic gaming. Pediatrics 2010;126:e1414-24. Ferguson, Salmond, and Modi FLA 5.1.0 DTD Š YMPD5831_proof Š 19 December 2012 Š 5:28 am Š ce 735 736 737 738 739 740 741 742 743 744 745 746 747 748 749 750 751 752 753 754 755 756 757 758 759 760 761 762 763 764 765 766 767 768 769 770 771 772 773 774 775 776 777 778 779 780 781 782 783 784 785 786 787 788 789 790 791 792 793 794 795 796 797 798 799 800 801