The latest in the long-standing debate over violent video games: They do cause players to become more physically aggressive.

An international study looking at more than 17,000 adolescents, ages nine to 19, from 2010 to 2017, found playing violent video games led to increased physical aggression over time.

The analysis of 24 studies from countries including the U.S., Canada, Germany and Japan found those who played violent games such as “Grand Theft Auto,” “Call of Duty” and “Manhunt” were more likely to exhibit behavior such as being sent to the principal’s office for fighting or hitting a non-family member.
“Although no single research project is definitive, our research aims to provide the most current and compelling responses to key criticisms on this topic,” said Jay Hull, lead author of the study published Monday in the Proceedings of the National Academy of Sciences.

“Based on our findings, we feel it is clear that violent video game play is associated with subsequent increases in physical aggression,” said Hull, associate dean of faculty for the social sciences at Dartmouth College in Hanover, New Hampshire, and the Dartmouth Professor of Psychological and Brain Sciences.

Video game violence has been a hot-button issue for more than a decade. Interest in research on video games’ potential for violence increased after it was learned Eric Harris and Dylan Klebold, the two teenagers who committed the Columbine High School shooting, played the first-person shooting computer game “Doom.”

But in a 2011 Supreme Court decision overturning California’s ban on the sale of violent video games to minors, the late Justice Antonin Scalia dismissed a link between the games and aggression. “These studies have been rejected by every court to consider them, and with good reason: They do not prove that violent video games cause minors to act aggressively,” he wrote in the majority opinion.

Since then, an American Psychological Association task force report in 2015 found a link between violent video games and increased aggression in players but insufficient evidence that violent games lead to criminal violence.

Earlier this year, President Donald Trump convened a video game summit a month after the February shooting that killed 17 people at Marjory Stoneman Douglas High School in Parkland, Fla. Prior to that meeting, Trump said, “I’m hearing more and more people say the level of violence on video games is really shaping young people’s thoughts.”

The Dartmouth researchers sought to reduce confusion about research findings – including disputes about the association between violent games and aggression – with a finely structured meta-analysis.

Those in the study who played violent games, whether frequently or infrequently, had an increase risk of aggressive behavior. The new research echoes Hull’s previous finding that playing violent games equates to about twice the risk of being sent to the principal’s office for fighting during an eight-month period, he said. A separate 2014 study he oversaw of violent video games in 2,000 families is one of the 24 included in the meta-analysis.

The effect is “relatively small, but statistically reliable. The effect does exist,” Hull said.

While there’s not research suggesting violent video games lead to criminal behavior, Hull’s previous research suggests players may practice riskier behaviors such as reckless driving, binge drinking, smoking and unsafe sex.

“A lot of people ask, do these games really cause these kids to behave aggressively? I would say that is one possibility,” he said. “The other possibility is that it’s a really bad sign. If your kids are playing these games, either these games are having a warping effect on right and wrong or they have a warped sense of right or wrong and that’s why they are attracted to these games. Either way you should be concerned about it.”

In the research paper, Hull and the co-authors say they hope the findings will help research move “past the question of whether violent video games increase aggressive behavior, and toward questions regarding why, when, and for whom they have such effects.”

Follow USA TODAY reporter Mike Snider on Twitter: @MikeSnider.