Girls who engaged in the game were more likely to gamble and have poor nutrition; boys were more likely to be exposed to violence.
Black boys were more likely to have played the game than white boys, and Pacific Islanders of both genders were more likely than whites to have tried playing, the researchers found.
However, Nystrom cautioned, there may not have been enough ethnic diversity in the sample to be sure that those findings would hold up.
Dr. Dennis Woo, a staff pediatrician at the UCLA Medical Center in Santa Monica, said he was surprised that the number of kids participating was that high. "Six percent is quite a few kids," he noted.
Parents can help their children avoid problems, he said, by being aware that age 13 is a time when youth are transitioning to adulthood, and trying to find themselves.
Be aware, Woo said, of your children's friends and their activities. Be alert to behavior changes, such as suddenly not doing well in school, because that might indicate they are getting involved in risky behaviors.
"I think it's still OK to have an open door policy," he said, striking a balance between giving them "alone time" in their room but also having access. "Remind them they are still subject to random searches."
Some parents are casual about risk-taking behavior in their pre-teens and teens, he said, reasoning that "kids will be kids." But he would tell those parents that "you really do want to be vigilant because some of the behaviors can have tragic consequences."
Nystrom agreed that parents need to talk to their children and stay aware of any warning signs of the game activity. That could include marks on the neck, red dots around the eyelid (reflecting hemorrhage) and unexplained headaches, he said.
Contact the child's health care provider right away if you suspect something, he said. At the child's annual wellness visit, the pedi
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