Piloting an unmanned aircraft in a warzone isn’t anything like playing a video game. According to a recent study conducted by the Air Force, drone pilots are just as emotionally invested and stressed during combat as their manned counterparts.

Over the course of a year, researchers interviewed and observed drone pilots to evaluate their emotional states and empathy. The Air Force was concerned that drone pilots would be “emotionally disengaged” and “basically treat warfare as a big video game.”

Instead, the study found that airmen were very emotionally engaged while carrying out drone strikes, and often worried about killing people or protecting their families.  “I don’t enjoy killing people,” said an anonymous airman quoted in the study. “I enjoy being good at my job. Lives hang in the balance based on your decisions.”

Study author Lt. Col. Joseph Campo said that none of the 100 interviewed airmen considered their jobs akin to playing video games. He also said that drone pilots often held back in missions when they felt that the collateral damage of an airstrike was too great to justify.

“There’s virtually no difference in emotion response rates to killing regardless of whether the air crew previously flew the A-10, was a security forces airman with multiple combat deployments, a load master in a C-17, or came into the Air Force and has been an….RPA crewman since we brought them into the Air Force,” Campo said.

Drone pilots are also prone to PTSD and other mental or health disorders.