Concern from parents, professionals, and the populace at large about the impact of the media on children and ado- lescents has grown steadily over recent years. Recent events, most prominently the school murders of the past 2 years, in Pearl, Mississippi; Jonesboro, Arkansas; Paducah, Kentucky; and Littleton, Colorado, have drawn attention to the volatile confluence of culture and psychopathology. It has become imperative for clinicians to understand the role of media exposure on children in order to diagnose and treat behavioral problems as well as to prevent further tragedies. This review synthesizes relevant media research since 1990 regarding the impact of media on children and ado- lescents. It begins by providing a historical overview through a brief summary of review articles, policy state- ments, and scientific books. This literature, while not new research, is important because it provides a historical context for the research of the 1990s. The following spe- cific categories of media were chosen for research review: television and movies, music and rock videos, advertis- ing, video games, and computers and the Internet. These were selected because they are standard components of the American child’s media diet, often occupying large amounts of time on a daily basis. HISTORICAL OVERVIEW Dietz and Strasburger’s review (1991) summarized the research of the previous 20 years, which demonstrated the multiple effects of television on child and adolescent cognition and behavior. Looking at topics ranging from cognitive development, to obesity, to aggressive behavior and violence, drug use, suicide, sexual activity, and the promotion of stereotyping, this article highlighted earlier findings and provided the basis for much of the recent research. From this point, particularly in the area of tele- vision and movies, the research became heavily oriented RESEARCH UPDATE REVIEW This series of 10-year updates in child and adolescent psychiatry began in July 1996. Topics are selected in consultation with the AACAP Committee on Recertification, both for the importance of new research and its clinical or developmental significance. The authors have been asked to place an asterisk before the 5 or 6 most seminal references. M.K.D. Impact of Media on Children and Adolescents: A 10-Year Review of the Research SUSAN VILLANI, M.D. ABSTRACT Objective: To review the research literature published within the past 10 years regarding the impact of media on children and adolescents. Method: Media categories researched with computer technology included television and movies, rock music and music videos, advertising, video games, and computers and the Internet. Results: Research prior to 1990 documented that children learn behaviors and have their value systems shaped by media. Media research since has focused on content and viewing patterns. Conclusions: The primary effects of media exposure are increased violent and aggressive behavior, increased high-risk behaviors, including alcohol and tobacco use, and accelerated onset of sexual activity.The newer forms of media have not been adequately studied, but concern is warranted through the logical extension of earlier research on other media forms and the amount of time the average child spends with increasingly sophisticated media. J. Am. Acad. Child Adolesc. Psychiatry, 2001, 40(4):392–401. Key Words: media, television, violence, sexual activity, substance use. 392 J. AM. ACAD. CHILD ADOLESC. PSYCHIATRY, 40:4, APRIL 2001 Accepted November 20, 2000. Dr. Villani is Medical Director, School Programs, Kennedy Krieger Institute, Baltimore. She is also Assistant Professor of Psychiatry, Johns Hopkins University School of Medicine, Baltimore. Reprint requests to Dr. Villani, Kennedy Krieger School, 1750 E. Fairmount Avenue, Baltimore, MD 21231. 0890-8567/01/4004-03922001 by the American Academy of Child and Adolescent Psychiatry.