All instruction are attached below.

Online Activity 1

Introduction:

Pick a particular mental health condition that you’re interested in (eating

disorder, depression, anxiety, etc.) Write an introductory paragraph based on the

research you find on the topic.

Body: (3 Paragraphs)

for the next three paragraphs find something from each one of the three readings

that you can connect to the mental health condition you chose. Reference or

quote what you find from each reading that connects to your mental health

condition in your three paragraphs.

Conclusion

References:

Reference 3 online references you used for the introductory paragraph.

ARTICLE IN PRESS
Psychology of Sport and Exercise 9 (2008) 576–594
1469-0292/$ –

doi:10.1016/j.


Correspon

E-mail add
www.elsevier.com/locate/psychsport
Narrative, identity and mental health: How men with serious
mental illness re-story their lives through sport and exercise

David Carless
a,�

, Kitrina Douglas
b

a
Carnegie Research Institute, Leeds Metropolitan University, Headingley Campus, Beckett Park, Leeds LS6 3QS, UK

b
University of Bristol, Bristol, UK

Received 1 June 2007; received in revised form 6 August 2007; accepted 23 August 2007

Available online 1 September 2007
Abstract

Objectives: It has been suggested that mental illness threatens identity and sense of self when one’s personal
story is displaced by dominant illness narratives focussing on deficit and dysfunction. One role of therapy,
therefore, is to allow individuals to re-story their life in a more positive way which facilitates the
reconstruction of a meaningful identity and sense of self. This research explores the ways in which
involvement in sport and exercise may play a part in this process.
Design: Qualitative analysis of narrative.
Method: We used an interpretive approach which included semi-structured interviews and participant
observation with 11 men with serious mental illness to gather stories of participants’ sport and exercise
experiences. We conducted an analysis of narrative to explore the more general narrative types which were
evident in participants’ accounts.
Findings: We identified three narrative types underlying participants’ talk about sport and exercise: (a) an
action narrative about ‘‘going places and doing stuff’’; (b) an achievement narrative about accomplishment
through effort, skill or courage; (c) a relationship narrative of shared experiences to talk about combined
with opportunities to talk about those experiences. We note that these narrative types differ significantly
from—and may be considered alternatives to—dominant illness narratives.
Conclusion: This study provides an alternative perspective on how sport and exercise can help men with
serious mental illness by providing the narrative resources which enabled participants to re-story aspects of
see front matter r 2007 Elsevier Ltd. All rights reserved.

psychsport.2007.08.002

ding author. Tel.: +44 7879 647227; fax: +44 113 283 7575.

ress: [email protected] (D. Carless).

www.elsevier.com/locate/psychsport

dx.doi.org/10.1016/j.psychsport.2007.08.002

mailto:[email protected]

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D. Carless, K. Douglas / Psychology of Sport and Exercise 9 (2008) 576–594 577
their lives through creating and sharing personal stories through which they rebuilt or maintained a positive
sense of self and identity.
r 2007 Elsevier Ltd. All rights reserved.

Keywords: Mental health; Identity; Physical activity; Schizophrenia; Narrative; Therapy
Introduction

In this article, we seek to contribute to dialogue regarding the psychological effects of sport and
exercise participation for people with serious mental health difficulties (e.g., Beebe et al., 2005;
Faulkner & Sparkes, 1999; Fogarty & Happell, 2005). As such, this work builds upon and
develops existing studies (Carless, 2007, in press; Carless & Douglas, 2004, in press; Carless &
Sparkes, 2007) which have explored the ways in which sport and exercise are experienced by men
with serious mental illness such as schizophrenia. A central focus of our ongoing interpretive
research is the ways in which involvement in sport and exercise can contribute to the process of
recovery in the context of serious mental illness.
In doing this work we are sharply aware of Davidson and Roe’s (2007) observation that the

‘‘dynamic interactions between the complexities involved in serious mental illness with those
complexities involved in the human beings who suffer from and recover from these illnesses result
in an extremely complex terrain, about which we still know very little’’ (p. 460). In recognition of
this uncertainty, we have chosen to utilise here a narrative psychological approach in an effort to
shed new light on the ways sport and exercise are experienced by men with serious mental illness.
Despite the increasingly widespread use of narrative approaches in mainstream psychology
(see Crossley, 2000; Dimaggio, 2006), there are few examples of its use in physical activity and
mental health research (see Carless & Sparkes, 2007) and narrative approaches remain relatively
rare in sport and exercise psychology in general (see Douglas & Carless, 2006, in press; Smith,
1999; Smith & Sparkes, 2002; Sparkes & Partington, 2003; Sparkes & Smith, 2003; Stelter, 2006).
However, as Sparkes (2005) notes, this approach has the potential to enrich our understanding
through developing ‘‘a more sophisticated appreciation of people as active social beings and focus
attention on the way personal and cultural realities are constructed through narrative and
storytelling’’ (p. 191). Before proceeding with this endeavour, it is first necessary to provide some
background on the concept of recovery in the context of serious mental illness and the narrative
theory which underlies our approach.
Recovery in the context of serious mental illness

According to several authors who have themselves experienced serious mental illness, there is
more to recovery than the alleviation of symptoms, deficits, and dysfunctions (e.g., Baker-Brown,
2006; Chadwick, 1997; Deegan, 1996; Repper & Perkins, 2003). When it comes to recovery,
Repper and Perkins (2003) suggest

The challenge facing people with mental health problems is to retain, or rebuild, a meaningful
and valued life, and, like everyone else, to grow and develop within and beyond the limits

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D. Carless, K. Douglas / Psychology of Sport and Exercise 9 (2008) 576–594578
imposed by their cognitive and emotional difficulties. Recovery is not about ‘getting rid’ of
problems. It is about seeing people beyond their problems—their abilities, possibilities, interests
and dreams—and recovering the social roles and relationships that give life value and meaning.
(p. ix)

A similar perspective has been more recently voiced by Davidson, O’Connell, Tondora, Lawless,
and Evans (2005) who, in attempting to establish a conceptual framework for the concept of
recovery, write

we have learned that recovery from serious mental illness does not require remission of
symptoms or of other deficits. Rather, recovery involves incorporation of one’s illness within
the context of a sense of hopefulness about one’s future, particularly about one’s ability to
rebuild a positive sense of self and social identity. (p. 484, 485)

Rebuilding a sense of self and a social identity is an important aspect of Davidson and Roe’s
(2007) characterisation of recovery in serious mental illness which they suggest is needed to
overcome the ‘‘loss of valued social roles and identity, isolation, loss of sense of self and purpose
in life’’ (p. 462). A common theme in diverse conceptions of recovery, then, seems to us to revolve
around the rebuilding or recreation of a sense of self, an identity, and a sense of purpose within
meaningful social roles and relationships. In order to explore these complex issues, and begin to
develop an understanding of how these kinds of changes might come about through involvement
in sport and exercise, we now turn to consider the social constructionist conception of narrative
theory which underpins this research.

Narrative, identity, and mental health

Narrative theorists (e.g., Brooks, 1994; McLeod, 1997) have suggested that mental health is in
some way related to one’s ability to create a story of one’s life. If this is the case, it seems likely
that an important link between narrative and mental health concerns the way in which identity
and sense of self may be developed and maintained through telling stories of our lives.

1
According

to Crossley (2000), creating and telling stories of one’s life is a necessary part of developing and
maintaining a coherent identity and sense of self because it is ‘‘through narrative [that] we define
who we are, who we were and where we may be in the future’’ (p. 67). In this light, stories may be
considered a way of linking one’s past, present, and future which allows the development of a
coherent sense of self that ‘makes sense’ within the context of one’s life experiences. Spence (1982)
suggests that ‘‘we are all the time constructing narratives about our past and future y the core of
our identity is really a narrative thread that gives meaning to life provided—and this is the big if—
that it is never broken’’ (p. 458). The maintenance of a coherent narrative thread, according to
McAdams (1993), provides a sense of meaning and purpose to one’s life which helps avoid malaise
and stagnation. Indeed in Baldwin’s (2005) terms, ‘‘maintaining this sense of coherence is an
overarching feature of a life-project and productive of well-being and (arguably) its loss is a
feature of mental ill-health such as in schizophrenia or post-traumatic stress disorder’’ (p. 1023).
1
The terms narrative and story are used interchangeably by some authors. We follow Frank (2000) in using the term

story to refer to a personal experiential account as told by a specific individual and the term narrative to refer to the

more general structure underlying a particular story.

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Importantly however, meaning and coherence are not inherent features of narratives, but
instead are created in the act of telling stories. In their research with men who acquired spinal cord
injury playing sport, Smith and Sparkes (2002) have shown how ‘‘coherence and the meaning of
experience is artfully constructed, occasioned, circumstantially formed and influenced by the
cultural conventions of telling’’ (p. 167). This finding is significant in that it begs the question of
how a person might create meaning and coherence in the absence of storytelling opportunities.
This is a real concern, we suggest, in mental health contexts as according to Baldwin (2005) the
experience of serious mental illness can in itself deny individuals both the ability and the
opportunity to author their own life story. As Baldwin (2005) puts it, as a result of ‘‘cognitive
difficulties or loss of language, individuals may lose the ability to construct and articulate a
coherent narrative’’ (p. 1023). Similarly, he suggests, an ‘‘individual’s interactions with others may
be restricted by a condition that results in decreased opportunities to launch and maintain
narratives’’ (Baldwin, 2005, p. 1023). In this regard, problems with thought processes,
communication, social withdrawal, and/or inactivity can together conspire to deny a person
with serious mental illness the opportunity to both create and share stories of his or her life. A
likely consequence of this denial, narrative theorists such as McLeod (1997) and Crossley (2000)
suggest, is that individuals are thereby limited or restricted in terms of the avenues through which
they may maintain or develop a coherent, meaningful life story by which to preserve or renew
identity and sense of self.

Narratives and culture

It is significant that, while stories are personal, they are at the same time shaped by cultural
factors. According to McLeod (1997), ‘‘Even when a teller is recounting a unique set of individual,
personal events, he or she can only do so by drawing upon story structures and genres drawn from
the narrative resources of a culture’’ (p. 94). Thus, a person’s own story is shaped and constrained
by narratives that circulate within the culture in which he or she is immersed. Frank (1995) has
described these as narrative types which he characterises as ‘‘the most general storyline that can be
recognized underlying the plot and tensions of particular stories’’ (p. 75). In Frank’s terms,
‘‘People tell their own unique stories, but they compose these stories by adapting and combining
narrative types that cultures make available’’ (p. 75).
In the context of serious illness, a powerful medical narrative acts to shape and constrain an

individual’s story about (and experience of) illness. Frank (1995) describes how, ‘‘The story of
illness that trumps all others in the modern period is the medical narrative. The story told by the
physician becomes the one against which all others are ultimately judged true or false, useful or
not’’ (p. 5). In particular, Frank (1995) suggests, the restitution narrative, a storyline that is ‘‘filled
out with talk of tests and their interpretation, treatments and their possible outcomes, the
competence of physicians, and alternative treatments’’ (p. 77), influences many people’s
experience of illness. The plot of this story, Frank suggests, follows the basic storyline of
yesterday I was healthy, today I’m sick, but tomorrow I’ll be healthy again.
While a restitution story may work for some illness experiences, it can be problematic in the

context of serious or chronic illness for which a ‘cure’ (i.e., a return to previous health as it once
was) may not be forthcoming. Restitution stories no longer work, Frank (1995) suggests, in the
context of long-term impairment which equates to some people’s experience of serious mental

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illness when restitution is not inevitable and a focus on the future can be problematic—or even
hopeless—because a future free of illness cannot be envisaged. Frank (1995) and Smith and
Sparkes (2005a) suggest that individuals experiencing chronic illness therefore need alternative
narrative resources by which to story their lives in order to prevent narrative wreckage and
thereby preserve or reinstate sense of self, identity, and mental health. At these times, as Baldwin
(2005) puts it, ‘‘to challenge disabling master narratives, counterstories that are individual,
enabling and meaningful need to be both constructed and realised’’ (p. 1027).

The therapeutic potential of sport and exercise

According to McLeod (1997) and Baldwin (2005), an important component of therapeutic
interventions for people with mental health problems is the opportunity to launch and maintain
personal stories which reinstate a sense of meaning, identity and coherence in a person’s life. In
this regard, White and Epston (1990) suggest that therapy should ‘‘open space for persons to re-
author or constitute themselves, each other and their relationships according to alternative stories
or knowledges’’ (p. 75). In so doing, individuals are able to create and share a life story which
‘makes sense’ within the context of both their experience and the cultural narrative types available
to them. According to McLeod (1997), this task is fundamental to psychological well-being and
mental health in that ‘‘the task of being a person in a culture involves creating a satisfactory-
enough alignment between individual experience and ‘the story of which I find myself a part’’’
(p. 27).
How might involvement in sport and exercise contribute to this process? We suggest a key issue

concerns the way that involvement in sport and exercise differs from mainstream pharmaceutical
interventions in that it can go beyond removing problems by contributing something positive to a
person’s life. According to Anthony (1993), this distinction is important in recovery terms:

There is the possibility that efforts to positively affect the impact of severe mental illness can do
more than leave the person less impaired, less dysfunctional, less disabled, and less
disadvantaged. These interventions can leave a person with not only ‘‘less,’’ but ‘‘more’’—
more meaning, more purpose, more success and satisfaction with one’s life. (Anthony, 1993,
p. 20)

Several positive benefits of this kind have been identified in existing literature. First, it appears
that sport and exercise activities provide opportunities for social experiences and interaction
which is valued by some users of mental health services (Carless & Douglas, 2004; Carter-Morris
& Faulkner, 2003; Faulkner, 2005). Second, involvement in sport and exercise can bring a sense of
meaning, purpose, optimism, and hope to the lives of some people with mental health problems
(Carless & Douglas, in press; Carless & Sparkes, 2007; Raine, Truman, & Southerst, 2002). Third,
participation in sport or exercise can boost some people’s self-esteem (Faulkner, 2005; Faulkner &
Sparkes, 1999). Finally, sport and exercise helps some individuals rediscover a sense of identity
(Carless, 2007, in press; Carless & Douglas, in press).
While previous research suggests some important ways in which sport and exercise can help

people with serious mental health difficulties, the question of how these changes come about is far
from resolved. We suggest that the previously discussed social constructionist conception of
narrative theory has the potential to provide fruitful insights into this question. Given that this

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D. Carless, K. Douglas / Psychology of Sport and Exercise 9 (2008) 576–594 581
project represents the first use of a social constructionist narrative approach to physical activity
and mental health research, in keeping with the ethos of interpretive research we attempt to
illuminate rather than pin down what Davidson and Roe (2007) recognise as ‘‘an extremely
complex terrain, about which we still know very little’’ (p. 460). Our purpose therefore is to
explore the ways in which narrative, identity and mental health relate to one another within the
specific context of sport, exercise and serious mental illness. Specifically, we focus on developing
understanding of how sport and exercise involvement can help some men with serious mental
illness through providing opportunities for the creation and sharing of personal stories which
facilitate the narrative (re)construction of identity and sense of self. We hope to achieve this by
exploring the kinds of stories 11 men with serious mental illness told about their experiences of
sport and exercise.

Method

Participants and procedures

The interpretive approach used in this study was strongly influenced by our recognition of the
potential challenges, difficulties, and risks of conducting research in the context of serious mental
illness. In particular, given our desire to obtain first person narrative accounts of sport and
exercise within the context of serious mental illness, it was necessary to conduct interviews which
provided participants with opportunities to tell their own stories. According to Stone (2004),
however, there is a risk in telling these kinds of personal stories in the context of mental illness:

to formulate a narrative will necessitate a willed passage into and through the same spaces of
self—thought, memory and emotion—in which the illness has been, and possibly still is, manifest
y All of this, I want to suggest, means the narrative journey may be a perilous one. (p. 20)

In an effort to minimise the dangers which may arise from talking about and ‘revisiting’
potentially traumatic life phases, we employed two strategies of ethnographic research which we
believed would reduce the risk of participants experiencing distress.
The first strategy involved striving to develop a high degree of trust, rapport, and familiarity

with participants. Specifically, following ethical clearance from the NHS Trust Research Ethics
Committee, I (David Carless) engaged in prolonged immersion in the field over an 18 month
period where he participated in the daily life of a vocational rehabilitation centre for people with
serious mental illness. During this time, I took part in sport and exercise groups as well as social
and day-to-day activities which helped build trust and rapport with potential participants. For
Kitrina Douglas, trusting relationships and familiarity with participants were established through
Kitrina attending the centre on a weekly basis and coaching a golf activity group which was
developed, organised, and run by both authors and offered alongside other physical activity
sessions at the centre. Potential participants were identified on the basis of: (i) their personal
experience of both serious mental illness and sport/exercise participation; (ii) their willingness to
take part in the research; and (iii) mental health professionals’ assessment that the individual was
sufficiently mentally well to participate. In total, 11 participants agreed to take part in the research
and provided informed consent. At the time of the research participants were aged between 24 and
43 and all were considered to be experiencing severe and enduring mental illness.

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D. Carless, K. Douglas / Psychology of Sport and Exercise 9 (2008) 576–594582
The second strategy involved utilising two distinct methods of data collection in an effort to
gain a rich and broad understanding of the background and context of participant’s experiences.
These methods were: (a) Participant observation. During sport and exercise activities and day-to-
day life at the rehabilitation centre field notes were compiled independently by both authors to
document observations, interpersonal exchanges, and personal reflections. (b) Semi-structured
interviews. A total of 16 interviews were conducted and each participant took part in between one
and three interviews each lasting from 20 to 90 min in duration. Participants were invited to talk
about: (i) their experiences in and through sport and exercise; (ii) particularly memorable sport or
exercise-related moments; (iii) their previous sport and exercise involvement; (iv) any ways in
which sport or exercise affected them. Prior to concluding the interview, participants were asked
whether there was anything else they would like to share regarding their experience of sport,
exercise, or mental health. Throughout the interviews, the researchers acted as ‘active listeners’ in
an attempt to assist the participant to talk about his own experiences in his own words. The
interviews were conducted within the familiar settings of the day centre or physical activity venue
and were audio recorded and transcribed verbatim with the exception of an interview with one
participant who did not want a tape recorder to be used.
Analysis of narrative

The first stage of analysis involved both researchers engaging in several close readings of the
interview transcripts and field notes to become immersed in the data. Next, we conducted a
content analysis using quotations as the unit of analysis (Sparkes, 2005) and following the process
described by Lieblich, Tuval-Mashiach, and Zilber (1998) as categorical-content analysis. The
findings of these analyses have been presented elsewhere (Carless, 2007; Carless & Douglas, 2004).
However, as Lieblich et al. (1998) note, ‘‘while the content is often more obvious and immediate to
grasp, researchers may prefer to explore the form of a life story because it seems to manifest
deeper layers of the narrator’s identity’’ (p. 13). Thus we conducted a third stage of analysis which
has been described by Smith and Sparkes (2006) as an analysis of narrative. These authors outline
several alternative analytical approaches to narrative research and suggest that researchers should
be clear in which approaches they employ in a particular study. For the purposes of this study, we
adopted the standpoint of story analyst who thinks about stories. From this standpoint we treat
stories as

‘data’ and use ‘analysis’ to arrive at, for instance, themes that hold across stories or delineate
types of stories. That is, story analysts step outside or back from the story, employ analytical
procedures, strategies, and techniques in order to explore certain features of the story (e.g.,
content or structure), and carefully engage in abstract theorization about the story from a
sociological, psychological and/or other disciplinary perspective. (Smith & Sparkes, 2006,
p. 185)

This standpoint contrasts with that of a storyteller ‘‘who performs a narrative analysis and thinks
with stories’’ (p. 185). In this class of inquiry, the product is a story which the researchers allow to
stand alone without further analysis or interpretation (see Carless & Sparkes, 2007 for an example
of narrative analysis in action).

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D. Carless, K. Douglas / Psychology of Sport and Exercise 9 (2008) 576–594 583
In this study, in Holstein and Gubrium’s (2000) terms, our interest was primarily in the whats of
storytelling (what happened to whom) as opposed to the hows (how the story is told). Thus, we
conducted what Sparkes (2005) calls an analysis of structure and form of participants’ stories in
recognition that ‘‘the formal aspects of structure, as much as the content, express the identity,
perceptions, and values of the storyteller’’ (Sparkes, 2005, p. 195). Specifically, this analysis
adhered to the process described in detail by Lieblich et al. (1998) as a holistic analysis of form
whereby we focused on ‘‘the formal plot and organisation of the narrative to tease out the distinct
structures that hold it together with a view to identifying it as a particular narrative type’’ (Smith
& Sparkes, 2007, p. 27). Through identifying common narrative types underlying participants’
stories of sport and exercise, we aimed to develop an understanding of the meaning of sport and
exercise within participants’ socio-cultural context.
Accordingly we now present our findings in the shape of three story types which were evident

within participants’ accounts of their sport and exercise experiences. We describe these as action,
achievement, and relationship narratives and illustrate the ways in which these narrative types
related to participants’ experiences in the context of sport and exercise activities.
Findings

An action narrative: ‘‘Going places and doing stuff’’

I like going out and about, like I said, people, you know, having a soft drink and stuff, playing
with people, enjoy yourself y keeping your mind busy, it’s going places and doing stuff.

A recurring motif around which participants’ stories and talk about their sport and exercise
involvement were structured was the concept of action. By ‘action’ we mean, in the words of one
participant above, ‘‘going places and doing stuff.’’ In this regard, the action narrative
incorporated an embodied experience of some kind, relating to some form of a physical process
or bodily movement. For some, taking action—having something to do and somewhere to go—
was expressed as being personally valued and meaningful even if only to the extent that it gave
them a reason to get out of the house:

It’s just that I’ve got an activity for the afternoon that I’m not sat watching TV something like
that. I watch so much it just sort of draws me. I need to sort of break away from a day indoors
and get out and do something y Its something to get me out of bed, get out of bed that
morning.

The action narrative is significant in that it differs markedly from the dominant narrative of
serious mental illness which often revolves around inactivity, of not doing much and not
having much to do, of withdrawing from life (see for example, Baker-Brown, 2006; Deegan, 1996;
Stone, 2006). For example, one participant described his experience of hospitalisation in a
psychiatric ward: ‘‘I was just bored in there—nothing to do. I didn’t do much. I was so bored.
I didn’t hardly do nothing. I just stayed in the ward and just went to bed and that was it.’’
Similarly, stories of other phases of illness were commonly characterised by inactivity: ‘‘Over at
my mother’s house I used to go to sleep a lot. I just switched off like y I used to sleep for hours
and hours.’’

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D. Carless, K. Douglas / Psychology of Sport and Exercise 9 (2008) 576–594584
Participants told how taking action affected them in positive ways. One young man, for
example, told how playing football (and being involved with football) provided a more positive
focus for his thoughts because at these times,

my mind’s occupied. I think other things. I don’t really think about bad things that I might
think about if I wasn’t doing something y It can happen with other things but I think sport is
such an active thing it tends to have …

O R I G I N A L P A P E R

Play and Joint Attention of Children with Autism in the Preschool
Special Education Classroom

Connie Wong • Connie Kasari

Published online: 17 February 2012

� Springer Science+Business Media, LLC 2012

Abstract The purpose of this study was to examine play

and joint attention in children with autism (n=27) as

compared to children with other developmental delays

(n=28) in public preschool special education classrooms.

The participants were observed in their classroom envi-

ronment for 2 h over 3 separate days. Results show that

children with autism spent more of their time unengaged

and less time engaged in symbolic play and joint attention

behaviors as compared to children with other develop-

mental delays. Additionally, teachers seldom focused

directly on symbolic play and joint attention in their

teaching. These findings suggest the importance of edu-

cating teachers to target play and joint attention skills in

their preschool special education classes, specifically for

children with autism.

Keywords Autism � Play � Joint attention � Engagement �
Preschool special education

Introduction

Young children with autism have significant social-com-

munication delays in symbolic play and joint attention.

Specific deficits in these areas distinguish children with

autism from typically developing children as well as from

children with intellectual disabilities (Mundy et al. 1986).

Furthermore, both symbolic play and joint attention are

significantly associated with later social (Sigman and Ru-

skin 1999), cognitive (Mundy et al. 2010; Stanley and

Konstantareas 2007) and communication development

(Charman et al. 2003; Kasari et al. 2008; Loveland and

Landry 1986; Mundy and Markus 1997; Mundy et al. 1986,

1990; Sigman and Ruskin 1999).

In symbolic play, children progress developmentally

from playing with toys functionally, such as in constructive

and manipulative play, to playing with toys symbolically

(Lifter et al. 1993). However, in comparison to typically

developing children, children with autism at the same

mental ages have significant delays in the development of

symbolic play (Jarrold et al. 1993; Baron-Cohen 1987).

Children with autism tend to manipulate toys or objects in a

rigid or stereotyped manner (Atlas 1990) and less often

spontaneously initiate creative symbolic play activities

(Jarrold et al. 1993; Libby et al. 1998). Beyond these

delays in play skills, children with autism are often object

focused with less frequent engagement of others into their

play activities (Kasari et al. 2010).

Joint attention, the ability to shift attention between

another person and an object or event, has a communica-

tive function in that these skills are used for the purpose of

sharing attention or interest with another person (Hobson

1989). Compared to MA-matched children with and with-

out intellectual disabilities, children with autism have

specific deficits in initiating and responding to joint

C. Wong (&)
Frank Porter Graham Child Development Institute, CB8040,

University of North Carolina at Chapel Hill, Chapel Hill, NC

27510, USA

e-mail: [email protected]

C. Wong

Psychological Studies in Education, University of California,

Los Angeles, CA, USA

C. Kasari

Semel Institute for Neuroscience and Human Behavior,

University of California, Los Angeles, CA, USA

123

J Autism Dev Disord (2012) 42:2152–2161

DOI 10.1007/s10803-012-1467-2

attention (Mundy et al. 1986). They are more likely to use

pointing and attention skills to regulate others’ behaviors

rather than to share interest (Mundy et al.).

The observed differences in play and joint attention

skills for children with autism are well documented, and

recent efforts to teach these skills have yielded positive

results (Jones et al. 2006; Lang et al. 2009; Martins and

Harris 2006; Stahmer 1995; Whalen and Schreibman

2003). There are few randomized controlled trials (RCTs)

in which joint attention and play skills have been examined

as outcomes of the intervention although the intervention

may have focused on these core areas of development

(Dawson et al. 2010; Green et al. 2010; Landa et al. 2011).

However, Kasari et al. (2006) showed that not only were

children with autism able to spontaneously generate sym-

bolic play activities and initiate joint attention with others

as a result of their focused RCT intervention, they also had

better language outcomes 1 year later (Kasari et al. 2008).

Obtaining change is critical on these areas of core deficit

for young children with autism since improvement is

linked to better developmental outcomes. However,

research studies have most often been conducted in labo-

ratory settings using skilled therapists to teach children.

While some recent studies demonstrate that parents can be

effective in improving play and joint attention outcomes

(Kasari et al. 2010; Rocha et al. 2007; Schertz and Odom

2007), children spend considerable time in preschool set-

tings with teachers.

It is not clear the extent to which teachers focus on these

core impairments for children with autism, even in class-

rooms that are autism-specific. For example, Sigman and

Ruskin (1999) reported that children with autism initiated

and participated in fewer social interactions with peers than

children with Down syndrome and children with other

developmental disabilities and tended to play in isolation.

Holmes and Willoughby (2005) also observed mostly sol-

itary or parallel functional play behaviors in seventeen 4- to

8-year old children with autism in the classroom. Addi-

tionally, Keen et al. (2002) reported that in their study of

eight children with autism, the children mostly requested

objects or protested; there were few instances of com-

menting. Further, teachers infrequently acknowledged

children’s communicative attempts (Keen et al. 2005).

The lack of focus given to symbolic play and joint

attention may be due to teachers’ lack of knowledge

regarding the importance of these skills. Although recent

reports identifying evidence-based practices for children

with autism include research support for the use of inter-

ventions that focus on play and joint attention (National

Research Council 2001; National Standards Project 2009;

Stansberry-Brusnahan and Collet-Klingenberg 2010),

teachers often have limited time and support to access

research findings (Closs and Lewin 1998). Furthermore,

there is limited research on classroom-based methods

(Brunner and Seung 2009). While Stahmer and Aarons

(2009) found that autism early intervention providers

generally reported favorable attitudes towards using evi-

dence-based practices, little is known regarding their actual

use of those strategies in practice. Finally, there is a lack of

emphasis on developing symbolic play and joint attention

in early childhood curricula. In a content analysis of

commonly adopted curricula for young children with aut-

ism, few contained symbolic play skills in an appropriate

developmental sequence and fewer curriculum guides

provided instruction for teaching joint attention skills.

When joint attention skills were mentioned, they were

often in the context of other goals such as pointing to show

receptive understanding rather than for sharing interest

(Wong and Kasari 2003).

Given the limited research in classrooms and with

teachers, the objective of this study was to build upon the

existing research focused on play and joint attention in

children with autism by examining those behaviors in the

preschool classroom setting as well as focusing on teach-

ers’ facilitation of play and joint attention. Specifically, we

asked (1) To what extent do children with autism initiate

play and joint attention across different types of settings in

the natural classroom environment? (2) What opportunities

do teachers provide for encouraging and/or developing

symbolic play and joint attention behaviors? (3) How do

teachers respond to children’s initiations of symbolic play

and joint attention in the classroom?

Methods

Participants

Recruited from a public early childhood learning center in

a suburban school district, participants included 55 pre-

schoolers analyzed in two groups: children with autism

(n = 27) and a mixed group of children with other dis-

abilities (n = 28). Children with autism all had a clinical

diagnosis of autism from a licensed psychologist or neu-

rologist. Though the majority of children in the mixed

group of other disabilities had speech/language delays,

other diagnoses included Down syndrome, cerebral palsy,

ADHD, and emotional/behavioral disorder.

Participating children ranged in age from 3 to 5 years

old with mental-age scores between 18.5 and 59 months as

calculated from the Mullen Scales of Early Learning

(Mullen 1995). The preschoolers were primarily boys, with

the proportion of males to females being higher in the

autism group, reflective of the gender ratio in autism.

Table 1 shows further demographic information. There

were no significant differences between the two groups.

J Autism Dev Disord (2012) 42:2152–2161 2153

123

The eleven participating classrooms had between six

and fourteen children taught by a certificated teacher and

two to four instructional assistants. All eleven teachers

were female and had between one and 32 years of expe-

rience teaching preschool special education. Table 2 pro-

vides further detailed background information. Nine of the

participating classrooms were self-contained non-categor-

ical classrooms and two were autism-specific; however, not

all children in the autism-specific classrooms had a diag-

nosis of autism. Regardless of class designation and child

diagnoses, the teachers all reported that classroom practices

were guided primarily by the school-designed curriculum

which was based off of state preschool standards and

supplemented by the Carolina Curriculum for Preschoolers

with Special Needs (Johnson Martin et al. 2004).

Measures

Classroom Observation

Children were observed in their classroom on three sepa-

rate mornings within a two-week period. Researchers blind

to children’s diagnosis continuously recorded the presence

of specific child behaviors and teacher behaviors towards

the target child in 5-min intervals for a total of approxi-

mately 2 h (M = 123.57, SD = 13.77 min) observation

time per child. Data was collected on a Palm V using Elan

2.0.1 (Sanders 2002), a shareware application designed for

behavioral data collection in educational settings. It is a

date and time-stamp recording application in which

templates can be created to record specific variables of

interest as well as anecdotal notes. When observed, all

participants had been in their classrooms for at least

3 months.

Table 3 describes the different play and joint attention

behaviors that were coded. In order to maintain higher

levels of interrater reliability, initiating joint attention

required the child to go beyond a coordinated joint look

(shifting gaze back and forth between an object/event and

another person) to also display a clear gesture of sharing

interest such as a show or a point. Thus, only higher level

joint attention skills were coded (Van Hecke et al. 2007).

Teacher behaviors were coded when they directly provided

any instruction in or prompts for play and joint attention as

well as if they responded to those behaviors. Researchers

recorded anecdotal notes to provide examples of the

behaviors. The average intraclass correlation coefficient

established between two independent coders was .86, with

a range of .81–.92 for the child and teacher play and joint

attention behaviors. Researchers also tracked children’s

engagement states (Adamson et al. 2004; Bakeman and

Adamson 1984) to calculate the percentage of time chil-

dren spent in each state. Intraclass correlation coefficients

for percent time in the different engagement states ranged

from .86 to .95.

Finally, the child’s activities in the classroom were

recorded as unstructured (e.g., free play, recess), structured

(e.g., circle, centers), or caregiving (e.g., toileting, snack).

Overall, children spent 56% of the time in structured

activities (M = 68.82, SD = 19.50 min), 32% in

Table 1 Child demographics

Autism (n = 27)

M (SD)/frequency (%)

Mixed disability (n = 28)

M (SD)/frequency (%)

V2/F

Chronological age (months) 51.70 (6.74) 49.76 (5.89) F(1,53) = .06, p = .80

Gender

Male 22 (82%) 18 (64%) V2(1) = 2.05, p = .15

Female 5 (18%) 10 (36%)

Ethnicity

Caucasian 13 (48%) 13(46%) V2(3) = .33, p = .95

Hispanic 3 (11%) 4 (14%)

Asian American 8 (30%) 7 (25%)

Other 3 (11%) 4 (14%)

Mullen scales of early learning

Mental age (months) 42.14 (9.19) 39.24 (9.42) F(1,52) = .16, p = .70

Receptive language age (months) 41.81 (9.77) 38.20 (10.42) F(1,52) = .27, p = .61

Expressive language age (months) 37.67 (10.70) 35.09 (9.26) F(1,52) = .12, p = .74

Mother’s highest level of education

High School 1 (4%) 1 (4%) V2(2) = .67, p = .72

Some College/Vocational Training 2 (7%) 4 (14%)

College/Professional/Graduate 24 (89%) 23 (82%)

2154 J Autism Dev Disord (2012) 42:2152–2161

123

unstructured activities (M = 39.45, SD = 11.91 min), and

12% in caregiving activities (M = 14.78, SD = 9.07 min).

For ease of interpretation, data was transformed so that the

variables of interest were divided by the total time in the

activity. There were no significant differences in activity

times between the two groups of children.

Structured Play Assessment (SPA; Ungerer and Sigman

1981)

The frequency, type, and level of spontaneous play

behaviors were coded from this videotaped 15-min inter-

action to determine highest play level mastery. While the

child and tester sat facing each other at a table, the tester

presented four groups of related toys including a tea set,

baby bottle, dolls, telephone, brush, mirror, doll furniture,

tissue, blocks, dump truck, and a garage.

To master a play level, the child had to spontaneously

initiate three play acts at a specific level of three different

types. For example, to reach mastery at the substitution

level, the child displayed a substitution with three different

objects (e.g., block as a cookie, paper as a blanket, and toy

bed as an airplane). Thus, for each child, we determined the

highest mastered level of play they demonstrated on the

assessment (not just the highest level of play shown).

Early Social-Communication Scales

(ESCS; Mundy et al. 1986)

The child’s nonverbal initiations and responses to joint

attention were scored from this videotaped 15-min semi-

structured assessment. The child and tester sat across from

each other with a set of toys to the side that were visible but

beyond reaching distance of the child. The tester, who was

Table 2 Teacher/classroom demographics

Teachers/classrooms

(N = 11)

M (SD)/frequency (%)

Teacher age (years) 49.89 (6.33)

Teacher ethnicity

Caucasian 9 (82%)

Hispanic 1 (9%)

Asian American 1 (9%)

Years of teaching

In current position 8.20 (7.94)

Total in similar position 16.30 (12.13)

Class age designation

3- to 4-year olds 5 (46%)

4- to 5-year olds 6 (54%)

Class type

Non-categorical self-contained class 9 (82%)

Autism specific self-contained class 2 (18%)

Class size

# of child study participants in the class 5.00 (2.45)

Total # of children in the class 10.27 (2.32)

Total # of adults assigned to the class 3.45 (.69)

Ratio of children to instructors 3.06 (.84)

Table 3 Behaviors coded in the classroom observation

Behavior Definition

Engagement

states

(adapted from Adamson et al. 2004)

Unengaged The child appears uninvolved with any specific person or object

Person-engaged The child is engaged in an interaction with another person

Object-engaged The child is solely focused on an object. The child is not communicating with another person in any way

Supported joint The child and another person are actively involved in the same object or toy, but the joint engagement is actively maintained

by the other person.

Coordinated joint The child initiates or is actively involved with and coordinates attention to both another person and the object to share

attention

Play (adapted from Lifter et al. 1993; Ungerer and Sigman 1981)

Child functional

play

The child creates combinations of objects and/or may extend familiar actions with objects in a pretend quality to self, others,

or to doll figures

Child symbolic

play

The child extends familiar actions to two or more figures or moves the figures as if they are capable of action. The child may

use one object to stand in place for another or pretends to use something that is not there. The child may adopt various

familiar or fantasy roles in a play theme

Joint attention (adapted from Mundy et al. 1986)

Child RJA The child responds (attentional or behavioral) to another’s bid (show or point to an object) for joint attention

Child IJA The child initiates (show or point) a bid for joint attention towards another person for sharing purposes

J Autism Dev Disord (2012) 42:2152–2161 2155

123

trained to elicit different responses, presented the different

toys one at a time.

From the assessment, the child’s mastery of responding

to and initiating joint attention was determined. To reach

mastery criteria of a specific skill, the child must have

demonstrated an act with at least two different objects on

the ESCS. In determining skill mastery for joint attention

initiations, only acts associated with eye contact were

considered intentional. We used these criteria to determine

what the child could demonstrate in joint attention at a

minimum ‘‘mastered’’ level across the assessment.

Mullen Scales of Early Learning (MSEL; Mullen 1995)

The MSEL assesses language, motor, and perceptual abil-

ities for children birth to about 5 years old. The visual

reception, fine motor, expressive language, and receptive

language subscales were used to calculate mental age.

Furthermore, the language subscales were used to report

receptive and expressive language age scores.

Demographic Information

The parents/guardians completed a demographic form to

obtain the child’s chronological age, gender, ethnicity, and

the parents’ highest level of education.

Teacher Survey

Teachers completed a questionnaire to collect teachers’

demographic information (age, gender, ethnicity, highest

level of education, and years of related teaching experi-

ence) as well as general classroom information (number of

students in the classroom and the number of adults in the

classroom).

Procedure

After obtaining informed parental consent to participate, all

assessments and observations were collected within

1 month for each child. Demographic forms and teacher

surveys were distributed, completed, and collected within

this same time frame.

Results

Primary analyses were conducted using ANCOVAs to

compare dependent variables of engagement, play, and

joint attention behaviors of children and teachers between

the autism and mixed disability groups and to explore if

there were differences across activities. Since Wong et al.

(2007) found that children with autism who had higher

mental age scores had higher rates of learning symbolic

play and joint attention skills when taught those skills, the

model included mental age as a covariate. Table 4 shows

the means and standard deviations of those behaviors in the

two groups and across activities.

Multilevel analyses were run using HLM 6.02 (Rau-

denbush et al. 2005) for dependent variables of play and

joint attention. While classroom differences were found,

the variance was primarily explained by individual child-

level variables rather than by classroom or teacher char-

acteristics; therefore, the following analyses were con-

ducted at the child level.

Engagement States

Children with autism spent more time in an unengaged

state than children in the mixed disability group

(F = 23.81, p .001), with significantly more time spent
unengaged during caregiving activities than in any of the

other activities (F = 6.01, p .05). Children with autism
were observed to be mostly eating/drinking or waiting in a

passive manner while children in the mixed disability

group were more likely to engage themselves by watching,

playing with something, or engaging another person.

Compared to children with other disabilities, children

with autism spent a higher percentage of time being object-

engaged in structured than in unstructured activities

(F = 5.31, p .05). Regardless of activity, children with
autism spent a significantly lower percentage of time in

person engagement than children in the mixed disability

group (F = 14.32, p .001).
The percentage of time spent in each of the engagement

states was further examined for its relation to each of the

main play and joint attention variables of interest. Table 5

shows a summary of the regression analyses.

Play

Most functional play occurred during unstructured activi-

ties (F = 19.68, p .001). However, compared to children
in the mixed disability group, while children with autism

initiated fewer functional play acts in unstructured settings,

they displayed more functional play in structured activities

(F = 8.64, p .01).
For symbolic play, no significant differences were found

between children with autism and children with other dis-

abilities. Although symbolic play acts were observed more

frequently in unstructured settings (F = 14.51, p .001),
those behaviors were present at relatively low levels

overall. During structured activities, play was not the pri-

mary objective. In fact, anecdotal notes reflected that cre-

ativity was often stifled in favor of adhering to the goals of

the activity. For example, one of the teachers redirected a

2156 J Autism Dev Disord (2012) 42:2152–2161

123

child to finish completing her puzzle when she started

moving the animal puzzle pieces as if they were walking

and making corresponding animal sounds.

Overall, children displayed more functional than sym-

bolic play acts in the classroom (t = 12.80, p .001). Of
the total play acts displayed in the classroom, approxi-

mately 94% were at the functional play level while only

about 6% were at the symbolic level. Furthermore, while

only 28 of the children displayed one or more play initia-

tions at the symbolic or dramatic level during the class-

room observations, 45 of the participants demonstrated

mastery criteria for playing at those levels during the

Structured Play Assessment.

Teachers did target more functional than symbolic play

skills with the children (t = 2.36, p .05). In examining
teachers’ teaching of functional play skills, a main effect of

activity type was found (F = 9.62, p .01) but no main
effect was found for the disability group. These results are

qualified by a significant interaction of group and activity

(F = 8.08, p .01). For children in the mixed disability

group, teachers targeted functional play more in unstruc-

tured activities than in structured activities. The pattern for

children with autism was the opposite, with more teacher

focus on functional play in structured settings and almost

none in unstructured activities. No significant effects were

found in teaching symbolic play.

An analysis on teachers’ responses to children’s play acts,

functional and symbolic, revealed that teachers responded at

higher proportions during structured activities than in any

unstructured and caregiving activities (F = 5.17, p .05).

Joint Attention

Although there were no significant differences in the fre-

quency of bids for joint attention between the two groups in

the classroom, children with autism responded to fewer

bids than children in the mixed disability group

(F = 17.40, p .001). While children with autism only
responded to 58.31% of opportunities, children in the

mixed disability group responded 74.94% of the time.

Table 4 Means and standard deviations of classroom behaviors across activities

Structured Unstructured Caregiving

Autism

M (SD)

Mixed

disability

M (SD)

Autism

M (SD)

Mixed

disability

M (SD)

Autism

M (SD)

Mixed

disability

M (SD)

Engagement states

% Unengagement 33.13 (13.58) 20.96 (10.92) 37.82 (21.05) 23.66 (13.44) 51.66 (22.52) 33.41 (20.77)

% Person engagement 6.99 (5.42) 11.74 (5.85) 6.93 (5.55) 12.25 (8.92) 2.92 (4.68) 7.01 (10.78)

% Object engagement 20.09 (8.76) 14.44 (7.65) 36.62 (12.79) 40.51 (14.64) 20.34 (17.63) 25.14 (17.72)

% Supported joint engagement 14.67 (5.69) 20.54 (11.96) 6.54 (5.24) 6.88 (4.50) 10.16 (7.88) 12.00 (18.92)

% Coordinated joint engagement 3.29 (3.78) 5.90 (6.25) 5.51 (7.52) 8.48 (10.07) 5.29 (6.53) 9.70 (13.92)

Play

Frequency of functional play acts 21.27 (17.75) 11.64 (14.84) 47.64 (52.94) 58.24 (44.95) 0 1.29 (5.81)

Frequency of symbolic play acts .96 (1.98) .56 (1.79) 3.33 (4.77) 5.47 (8.97) .22 (1.15) .27 (1.39)

Frequency of teacher prompts

for functional play

1.31 (3.00) .76 (2.24) .09 (.36) 2.00 (3.34) 0 0

Frequency of teacher prompts

for symbolic play

.29 (.63) .40 (1.12) .09 (.36) 1.02 (3.41) 0 0

% of teacher responses to child’s play acts .21 (.56) .27 (1.00) .10 (.48) .25 (1.01) – –

Responses to joint attention (RJA)

Frequency of teacher bids for JA 72.13 (36.61) 71.38 (25.19) 15.53 (13.21) 14.78 (8.84) 22.87 (29.13) 16.84 (12.67)

% of child RJA to bids for JA 62.82 (15.65) 75.22 (12.05) 59.60 (28.52) 69.92 (21.31) 44.55 (34.25) 77.73 (18.92)

Frequency of teacher prompts for RJA .58 (1.15) .44 (.81) .04 (.23) 0 0 0

% of teacher responses to child’s RJA 0 .60 (2.13) 0 0 0 0

Initiations of joint attention (IJA)

Frequency of IJA 17.44 (13.17) 31.02 (20.56) 18.98 (19.34) 31.38 (27.34) 19.40 (22.95) 39.56 (54.90)

Frequency of teacher prompts for IJA .73 (1.48) .87 (2.57) .38 (.94) 0 .11 (.58) 0

% of teacher responses to child’s IJA 49.89 (17.39) 43.45 (13.89) 41.38 (24.46) 35.18 (18.94) 41.97 (36.03) 48.71 (26.87)

Frequencies have been calculated as acts per second, * p .05, ** p .01, *** p .001

J Autism Dev Disord (2012) 42:2152–2161 2157

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Teachers did initiate more joint attention acts towards

children during structured activities than in the other

activities (F = 5.50, p .05). However, the occurrence of
teachers instructing children to respond to their bids for joint

attention was very low. When teachers did teach children to

respond, they were mostly telling children to ‘‘look’’ when

they showed or pointed to something. Moreover, teachers

seldom responded to or praised children for attending to their

requests for joint attention.

Consistent with results from the ESCS, children with

autism initiated fewer joint attention skills than children in

the mixed disability group (F = 10.92, p .01) across all
activity types in the classroom. Furthermore, teachers

taught children to initiate joint attention acts at low fre-

quencies. Anecdotal notes suggest that when teachers did

teach children to initiate joint attention acts, it was usually

in the context of teaching other academic or language

skills. For instance, teachers would physically help shape a

child’s hand into a point for them to identify the correct

answer to their question. In such a case, the correct answer

would usually be an object or picture and the goal was

often to test comprehension (e.g., labeling, color/shape/

letter identification). No significant differences were found

between the teachers’ treatment of children with autism

and children in the mixed disability group.

In an examination of teachers’ responses to children’s

initiations of joint attention, no significant effects were

found. However, while teachers would respond by looking

towards what the child wanted to share, they rarely rec-

ognized and reinforced shows and points as joint attention

behaviors.

Discussion

The results of this study confirm that children with autism

showed fewer play and joint attention behaviors than

children with other disabilities in their classrooms as would

be predicted by previous assessment studies (e.g., Mundy

et al. 1986). Teachers in the classroom provided minimal

teaching of play and joint attention and responded to those

behaviors at low levels in the classroom setting. Of particular

note is that teachers did not adjust their teaching to address

these developmental domains and teacher and classroom

variables were not associated with teacher performance.

Engagement

Most striking, the results indicated that children with aut-

ism spent 37% of the observed time in an unengaged state,

where, by definition, they were not purposefully attending

to or interacting with objects or other people. Indeed, the

results of this study show that the greater percentage of

time spent in an unengaged state, the less likely children

displayed play and joint attention skills. Children with

autism likely have more difficulty sustaining attention to

some of the activities in the classroom than children with

other developmental delays, and probably require adult

facilitation.

Furthermore, children with autism also have increased

difficulty in initiating engagement with other people.

Although all children spent fairly equivalent amounts of

time engaged with objects, children with other disabilities

were more likely to initiate engagement with other people,

either teachers or other peers in the classroom. …

Attractiveness and Rivalry in Women’s Friendships
with Women

April Bleske-Rechek & Melissa Lighthall

Published online: 9 March 2010
# Springer Science+Business Media, LLC 2010

Abstract Past research suggests that young women perceive their same-sex friends
as both facilitating the pursuit of desirable mates and competing for access to
desirable mates. We propose that similar levels of physical attractiveness between
young adult female friends might be one explanation for the opposing forces in their
friendships. Forty-six female friendship pairs completed questionnaires about
themselves, their friend, and their friendship; in addition, each woman’s picture
was rated by a set of nine naive judges. Friends were similar in both self-rated and
other-rated level of attractiveness. Within-pair analyses revealed that women agreed
on which friend was more attractive, and the less attractive members of each
friendship pair (by pair consensus as well as outside judges’ ratings) perceived more
mating rivalry in their friendship than did the more attractive members of each
friendship pair. We offer directions for research on women’s friendships over the
lifespan.

Keywords Women’s friendships . Same-sex friendship . Physical attractiveness .

Rivalry

Bestselling novels in the United States and elsewhere, such as The Jane Austen Book
Club, Reading Lolita in Tehran, Memoirs of a Geisha, and A Thousand Splendid
Suns, celebrate the unique architecture of friendships between women. Scholarly
books on friendship, too, are numerous, with more of them devoted to women’s
friendships than to men’s. Books on women’s friendships emphasize the opposing
forces that appear to define these relationships. Three of the top Amazon.com
(January 2009) hits for books on female friendships, for example, portray juxtaposed
forces in women’s friendships: Secrets and Confidences: The Complicated Truth
about Women’s Friendships (Eng 2004), Between Women: Love, Envy and

Hum Nat (2010) 21:82–97
DOI 10.1007/s12110-010-9081-5

A. Bleske-Rechek (*) : M. Lighthall
Department of Psychology, University of Wisconsin-Eau Claire, Eau Claire, WI 54702–4004, USA
e-mail: [email protected]

Competition in Women’s Friendships (Eichenbaum and Orbach 1989), and Best
Friends: The Pleasures and Perils of Girls’ and Women’s Friendships (Apter and
Josselson 1998).

Empirical research on emerging and young adults corroborates what literary
scholars have suggested: Women perceive both benefits and costs in their friendships
with women (Bleske and Buss 2000). On one hand, young women frequently report
that their female friendships provide companionship and emotional support (Rose
1985), and that their female friends give them mating advice and accompany them in
mate-seeking endeavors (Bleske and Buss 2000; Gottman and Mettetal 1986). On
the other hand, women also report that their female friendships take up a lot of time
and are emotionally draining (Hays 1988; Micke et al. 2008), and that their female
friends make them feel bad about themselves and compete with them for attention
from desirable potential romantic partners (Bleske and Buss 2000). We conducted
the current study to test the proposal that similar levels of physical attractiveness
between female friends is one factor underlying the opposing forces in women’s
friendships.

One reason to expect that female friends are similar in physical attractiveness is
data showing that friends are similar on a variety of other dimensions, some of
which may be linked to similarity in attractiveness. For example, friends tend to
have similar interests and values, which may be tied to similarity in health-
promoting or appearance-enhancing behaviors. Friends tend also to be similar in age,
level of education, family background, income, religious views, political views, and
the activities they enjoy (Johnson 1989; Tolson and Urberg 1993; see Fehr 1996 for
a review).

There are multiple, related explanations for previously observed similarities
observed among friends. First, according to theories of cognitive consistency (Heider
1958), humans are driven by a need for balance, and thus we prefer to be around
individuals who perceive issues and other people the same way we do. Relatedly, the
logic of Strategic Interference Theory (Buss 2004) suggests that we are oriented
toward interaction partners who will help us achieve our goals. From this
perspective, we are more likely to achieve our goals when we are allied with others
who are moving toward those same goals. For example, it may be easier for women
to find and meet potential long-term mates with certain qualities (such as financial
capacity and high levels of commitment intent) if they ally themselves with another
woman looking for those qualities, even if they might have to compete with her later
for access to one or more of those mates.

A second explanation of observed similarities between friends comes from an
individual differences perspective. Individuals’ education, abilities, interests, and
values guide the environments they select for themselves and so they are more likely
to spend time with similar others than with dissimilar others (Scarr and McCartney
1983). This idea of “niche-seeking” may be important for friendship formation,
because individuals increasingly like those with whom they come in frequent contact
(Hamm et al. 1975; Morinaga and Matsumura 1987). For example, women who
report less willingness to engage in casual sex differ from their unrestricted
counterparts in the tactics they use to attract mates, such as dressing conservatively
(Bleske-Rechek and Buss 2006). These women may come into contact with each
other more frequently than expected by chance and develop friendly attitudes toward

Hum Nat (2010) 21:82–97 8383

each other as a product of their more frequent contact. In indirect support of this
possibility, female friends report similar attitudes toward engaging in casual sex
(Preder et al 2006).

The demands of mate attraction and competition might provide the best
explanation for why we would expect female friends to be similar in their level of
physical attractiveness. Because men place a premium on physical attractiveness,
competition among women to attract men centers heavily on their level of
attractiveness (Buss 2003); thus, women should not want a friend to be much more
attractive than they are because then they might look less desirable in comparison to
their friend, but at the same time women should not want a friend to be much less
attractive than they are because that might inhibit their ability to gain attention or
interest from men when together. Women should prefer friends who are attractive
enough to attract desirable males, yet not so attractive that they steal all the attention
of those desirable males.

Very little research has actually addressed the question of friends’ similarity in
attractiveness. The most reliable study (Cash and Derlega 1978), which involved 24
pairs of close female friends rated by two observers, showed a friendship pair-wise
correlation of 0.40. In another study (McKillip and Riedel 1983), two groups of
close and casual female friend dyads were rated by just one observer and yielded
pair-wise associations of 0.01 and 0.13, respectively. Finally, Murstein (1971)
describes a study of a girls’ cooperative at a New England college in which 26
women ranked every other person in attractiveness; reciprocal best friends were
actually dissimilar in ranked attractiveness (r=−0.49). Besides the potential for
restricted range operating in any select sample of women living together, the sample
size of 26 and requirement of reciprocal best friend nominations suggests that the
exact number of dyads was no more than 13 and probably less than that (no specifics
are offered in the original text). Overall, the previous studies do not provide a clear
pattern of findings (Feingold 1988). Thus, we designed the current study to provide
a sound test of the hypothesis that female friends are similar in both their self-
perceived and other-perceived levels of attractiveness.

Similar levels of attractiveness would indicate that two female friends are more
similar to each other in attractiveness than are two women paired at random (Cash
and Derlega 1978). Such similarity, however, would not indicate identical levels of
attractiveness, and in each friendship pair there is likely to be one friend who is
(even slightly) more attractive than the other. As mentioned previously, women
compete intensely over physical attractiveness to attract and keep their mates (Buss
1988, 2003; Buss and Dedden 1990; Buunk and Dijkstra 2004; Dijkstra and Buunk
2002; Tooke and Camire 1991), so friend asymmetries in attractiveness have the
potential to create mating rivalry between two female friends. In support of this
possibility, Tesser and colleagues (Tesser and Campbell 1982; Tesser et al. 1989)
showed that individuals are threatened by having a friend perform better than them
on characteristics that are important to their sense of self (in their research, for
example, social sensitivity). Physical attractiveness is important to women’s own
perception of their desirability as well as others’ perception of their desirability;
therefore, having a friend who is more attractive might exert a negative contrast
effect on women’s perceptions of themselves as well as force them to put forth more
costly effort to attract a mate. Given that it should be threatening and perhaps even

84 Hum Nat (2010) 21:82–97

costly, then, for women to have a friend who is more attractive than themselves, we
hypothesize that women who perceive themselves as less attractive than their friends
perceive their friends as mating rivals. We predict that (1) Women who perceive
themselves as less attractive than their female friend will perceive more mating
rivalry in their friendship than will women who perceive themselves as more
attractive than their female friend; (2) Within friendship pairs, the woman whom
both friends say is less attractive will perceive more mating rivalry in the friendship
than will the woman whom both friends say is more attractive; and (3) Within
friendship pairs, the woman rated as less attractive by outside judges will perceive
more mating rivalry in the friendship than will the woman rated as more attractive by
outside judges.

Method

Participants

Forty-six pairs of female friends from a large Midwestern university in the United
States participated. The 92 women were all heterosexual and of traditional college
student age (19.3±1.2 years). Their friendships varied from 2 weeks to 10 years of
duration; the median friendship duration was 13 months (M=21.5 months, SD=
22.9 months). Ninety-one women were Caucasian; one was Asian. Of the 92
women, 63 (68%) were single or casually dating and 29 were in a committed
romantic relationship. Friends were not similar in relationship status, #24 ¼ 3:14,
p=0.53.

Forty-six women participated in partial fulfillment of a course research
participation requirement of several lower-level psychology courses. The study
was advertised as an investigation of “sources of content and contention in women’s
friendships,” and women signed up to participate under the requirement that a same-
sex friend who was not a dating partner or family member would accompany them
to the one-hour session.

Materials and Procedure

Friendship pairs were run in small group sessions. Pairs arrived at the session
together. Each woman was given a friendship number and letter (e.g., “4A” and
“4B”) and then pairs were separated and taken to different rooms to complete
questionnaires that were pre-identified with the friendship numbers and letters. As
part of a broader questionnaire about themselves, their friend, and the friendship,
participants responded to several items to assess perceptions of attractiveness. They
responded to the question, “Compared with other women your age, how physically
attractive are you?” The nine-point scale ranged from “Not at all Attractive” to
“Average” to “Extremely Attractive.” Later on in the questionnaire, they also
responded to that question about their friend: “Compared with other women her age,
how physically attractive is your friend?” The nine-point scale ranged from “Not at
all Attractive” to “Average” to “Extremely Attractive.” At another point in the
questionnaire, participants compared themselves with their friend: “Which of the

Hum Nat (2010) 21:82–97 8585

following best describes how you and your friend compare in physical attractiveness?”
The seven-point scale ranged from “I Am Much More Attractive than She Is” to “We
are the Same” to “She Is Much More Attractive than I Am.” We used both seven-point
and nine-point scales because students who piloted our questionnaires told us that
varied scales prevented them from falling into a response set.

In the middle of the questionnaire, participants reported the degree to which they
thought 87 different forms of confluence and conflict characterized their friendship
(e.g., “I can trust her with my secrets” and “She doesn’t always tell me the truth”).
Embedded within the 87 statements were five of particular interest to this study
because they assessed mating rivalry. These items were as follows: “She flirts with
guys I am interested in,” “It is harder to meet guys when she is around,” “I feel
undesirable when she’s around,” “I feel in competition with her for attention from
members of the opposite sex” and “I feel unattractive in comparison to her.” The
seven-point scale ranged from “Disagree Entirely” to “Neither Agree nor Disagree”
to “Agree Entirely.” Responses to the five rivalry statements showed high internal
consistency (α=0.80) and so were averaged for primary analyses.

Upon completion of the questionnaire, and with their consent, participants were
photographed against a white wall along a well-lit hallway. The photo was in color
and of the head and neck only. In previous studies our lab found that women smiled
unless told otherwise. Hence, to go with women’s default tendency and to obtain
some degree of consistency in expression, we instructed the women to smile. Photos
were cropped so that no picture showed anything beyond the neck. Ninety of the 92
participants (the two dissenters were friends) consented to having their photos
judged for subsequent research purposes.

Two years after data collection was complete, a naive set of five female and four
male undergraduate students from lower-level psychology courses rated the 90
pictures. These judges were 19 and 20 years old, and therefore of the same general
age as our original participants were when photographed. Judges did not know they
were rating women who had come in as members of friendship pairs. In addition,
pictures were shuffled so women in the same friendship pair were not judged
immediately before or after one another. Three female and two male judges viewed
the pictures in one order; two female and two male judges viewed the pictures in
exact reverse order. Judges rated each woman on apparent intelligence, physical
attractiveness, and sexiness (e.g., “Compared with other women her age, how
physically attractive is this woman?”). Judges provided their responses on nine-point
scales ranging from “Not at all” to “Average” to “Extremely.” Judges were instructed
to place an “X” through the rating form for any woman they had seen before, but
they left no “X” marks and in the post-rating session debriefings we clarified that the
judges did not recognize any of the women they had rated.

Attractiveness and sexiness ratings were highly correlated, r90=0.89, p<0.001; however, in order to compare them directly with women’s self-ratings, we used only the physical attractiveness ratings. Male and female judges’ ratings of the women’s physical attractiveness were highly reliable (male α=0.80, female α=0.78), so they were averaged (overall α=0.87). The nine judges’ ratings of sexiness demonstrated a similar degree of consensus (α=0.86); however, judges did not demonstrate consensus in their impressions of intelligence (α=0.62). Hence, analyses below involving intelligence include only self-reports from the original female participants. 86 Hum Nat (2010) 21:82–97 Results We first generated descriptive statistics on the variables of interest in this study: self- perceived attractiveness, other-perceived attractiveness, and self-reported mating rivalry in the friendship. On each of these variables, the women identified as “Friend A” (this was by chance, depending on which friend the researcher approached first when the friendship pair entered the lab) did not differ, on average, from the women identified as “Friend B” (paired-samples t-test p values > 0.28). Thus, we report
descriptive statistics for the sample as a whole.

Women’s ratings of their own attractiveness (M=5.70, SD=1.26) were higher
than judges’ ratings of their attractiveness (M=4.45, SD=1.43), t89=7.09, p<0.001. However, women’s self-rated attractiveness levels were positively associated with judges’ ratings of their attractiveness, r90=0.36, p<0.001. Women reported relatively low levels of mating rivalry in their friendships (M=2.30, SD=1.15). Women’s relationship status (involved versus not involved) was not related to their own or their friend’s perception of mating rivalry in the friendship, nor was women’s sexual history (reported number of sex partners) or discrepancy between friends in sexual history (all p values >0.11).

Similarity in Physical Attractiveness

Our first hypothesis was that women friends would be similar in both self-perceived
and other-rated levels of attractiveness. This hypothesis was supported. Female
friends’ self-rated levels of physical attractiveness were moderately and positively
associated, r46=0.30, p=0.04. This effect was verified via scatter plot; moreover,
when we reassembled the data into twenty different sets of random friendship pairs
(see Luo and Klohnen 2005), the correlation coefficients ranged from−0.22 to +0.32,
with a mean coefficient of−0.003. The positive association between friends’ self-
rated attractiveness also does not appear to be a product of women perceiving
themselves as similar to their friends, because women’s ratings of their own
attractiveness correlated only weakly with their ratings of their friends’ attractive-
ness, r92=0.22, p=0.04.

Outside judges’ ratings of female friends’ levels of attractiveness were strongly
correlated, r45=0.61, p<0.001. Again, this effect was verified via scatter plot, as displayed in Fig. 1. In further validation of the effect, correlation coefficients from twenty sets of randomly constructed friendship pairs ranged from−0.34 to +0.24, with a mean coefficient of−0.01. Attractiveness Discrepancies and Rivalry Our second hypothesis was that women who perceive themselves as less attractive than their friends perceive their friends as mating rivals. The first prediction to follow from this hypothesis is that women who perceive themselves as less attractive than their female friend will perceive more mating rivalry in their friendship than will women who perceive themselves as more attractive than their female friend. Indeed, women’s perception of their friend’s attractiveness, relative to their own, was associated with their perception of rivalry in the friendship, r91=0.47, p<0.001. This Hum Nat (2010) 21:82–97 8787 effect replicated within each of the individual items comprising the mating rivalry composite (all p values<0.06). Notably, and in support of the specificity of the predicted effect, women’s perception of mating rivalry in their friendship was not linked to perceived discrepancy between their own and their friend’s level of intelligence, r91=−0.07, p=0.51. We also explored discrepant attractiveness and perceptions of rivalry by splitting the women into three groups according to their response to the question comparing their own and their friend’s attractiveness. The original scale had seven check boxes ranging from “I Am Much More Attractive than She Is” (scored as 1) to “We are the Same” (scored as 4) to “She Is Much More Attractive than I Am” (scored as 7). We placed women who checked one of the first three boxes (1 to 3) in the self > friend group,
women who checked the fourth box in the self = friend group, and women who checked
one of the last three boxes (5 to 7) in the self < friend group. As displayed in Fig. 2, women’s perception of their own attractiveness, relative to their friend’s attractiveness, was tied to their perception of rivalry in the friendship, F2, 88=15.23, p<0.001, partial η2=0.26. Post hoc analyses revealed that women who thought their friend was more attractive felt more rivalry in their friendship (M=3.35, SD=1.48) than did women who thought they and their friend were equally attractive (M=2.35, SD=1.04), p= 0.05, and more rivalry than did women who thought they were more attractive than their friend (M=1.85, SD=0.70), p=0.001. In contrast to what we expected on the basis of literature showing costly competition among closely matched non-human rivals (Enquist and Jakobsson 1986; Leimar et al. 1991), women who thought they and their friend were equally attractive did not report significantly more rivalry compared with women who thought they were more attractive than their friend, p=0.11. Fig. 1 Scatterplot of the similarity between female friends’ levels of physical attractiveness, as rated by naive judges 88 Hum Nat (2010) 21:82–97 Our second prediction to follow from the hypothesis that attractiveness discrepancies are tied to rivalry is that, within friendship pairs, the woman whom both friends say is less attractive will perceive more mating rivalry in the friendship than will the woman whom both friends say is more attractive. Indeed, female friends did not report similar levels of rivalry in their friendship, r45=0.04, p=0.81. We conducted comparisons to determine if differences in perceptions of rivalry within friendship pairs varied systematically according to perceived differences in attractiveness. To do this, we first created a variable that reflected the discrepancy between Friend A’s and Friend B’s reports of rivalry in the friendship. On this variable, which we call Rivalry Discrepancy Score (RDS), a positive (+) value indicates that Friend A perceives more rivalry than does Friend B, and a negative value (−) indicates that Friend B perceives more rivalry. We calculated the mean RDS for friendship pairs in which the friends agreed that Friend B is more attractive (RDS is predicted to be positive) and the mean RDS for friendship pairs in which the friends agreed that Friend A is more attractive (RDS is predicted to be negative). The results of these analyses are displayed in Fig. 3. As shown in the figure, friends’ perceptions of rivalry differed systematically as a function of perceived differences in attractiveness, F2, 42=4.92, p=0.01, partial η 2= 0.19. Among the pairs who agreed that Friend B was more attractive, the mean rivalry discrepancy score (M= 0.76, SD=1.51) was significantly above zero, one-sample t16=2.09, p=0.03. Among the pairs who agreed that Friend A was more attractive, the mean rivalry discrepancy score (M=−0.94, SD=1.60) was significantly below zero, one-sample t12=2.11, p= 0.03. Among the 15 pairs who disagreed about who was more attractive, the mean rivalry discrepancy score (M=0.16, SD=1.33) was not significantly different from zero, t14=0.47, p=0.68. Fig. 2 Women’s perceptions of rivalry in their friendship, as a function of whether they believe they are more attractive than, equally as attractive as, or less attractive than their friend Hum Nat (2010) 21:82–97 8989 The third prediction to follow from the hypothesis that attractiveness discrep- ancies are tied to rivalry is that, within friendship pairs, the woman rated as less attractive by outside judges will perceive more mating rivalry in the friendship than will the woman rated as more attractive by outside judges. To test this prediction, we computed a new variable to index the magnitude and direction of discrepancy in judges’ ratings of Friend A versus Friend B for each pair of friends. To the extent that judges rated Friend A as more attractive than Friend B, the Rated Attractiveness Discrepancy Score was positive, and to the extent that judges rated Friend B as more attractive than Friend A, the Rated Attractiveness Discrepancy Score was negative. In confirmation of our prediction, Rated Attractiveness Discrepancy Score and Rivalry Discrepancy Score were negatively correlated, r44=−0.36, p=0.02. As displayed in Fig. 4, the more that judges’ attractiveness ratings favored Friend A over Friend B (a positive attractiveness discrepancy score), the more rivalry was reported by Friend B relative to Friend A (a negative rivalry discrepancy score); likewise, the more that judges’ attractiveness ratings favored Friend B over Friend A (a negative attractiveness discrepancy score), the more rivalry was reported by Friend A relative to Friend B (a positive rivalry discrepancy score). Discussion In the current research, we predicted and documented that young adult female friends are similar to each other in their level of physical attractiveness. Our prediction was founded in various theoretical perspectives (Cognitive Consistency Fig. 3 Discrepancies in friends’ perceptions of mating rivalry in the friendship, as a function of friends’ reports of which friend is more attractive 90 Hum Nat (2010) 21:82–97 Theories, Strategic Interference Theory) and the logic of mate attraction, which emphasize the interpersonal benefits associated with allying oneself with similar others. Our prediction also was founded in past research showing that friends are similar on other dimensions, such as their interests, social attitudes, and education level (see Fehr 1996 for a review). Similarity between romantic partners is quite substantial as well (e.g., Bleske-Rechek et al. 2009; Luo and Klohnen 2005; Vandenberg 1972); taken together with previous research on friend and romantic partner similarity on a variety of dimensions, our findings on friend similarity in attractiveness suggest that similarity is a defining characteristic of both friendships and mateships. We also hypothesized that, although young female friends may be similar to each other in their level of attractiveness, the perception of any discrepancies between them in attractiveness would be tied to perceptions of their friendship as involving mating rivalry. In line with this prediction, we documented that less-attractive friends experience more rivalry in their friendship than do their more-attractive counterparts. Indeed, our association between female friends’ reports of rivalry in their friendship and judges’ ratings of female friends’ attractiveness levels suggests that outsiders are likely to identify which member of a given pair of friends experiences more mating rivalry—merely through judgments of the women’s physical attractiveness. Self- and Others’ Judgments of Attractiveness Friends’ self-ratings of attractiveness were moderately correlated (r=0.30), and friends’ attractiveness ratings from outside observers were highly correlated (r=0.61); the Fig. 4 Scatterplot of the association between discrepancies in judges’ ratings of friends and discrepancies in friends’ perceptions of mating rivalry in the friendship Hum Nat (2010) 21:82–97 9191 difference between these two correlation coefficients tends toward significance (p= 0.07) and raises the question of what exactly is similar between women friends, or what exactly is perceived similarly. Friends’ ratings of their own attractiveness, which were moderately similar, likely included not only their perceptions of their facial attractiveness, but also their perceptions of their bodily strengths and weaknesses. In addition, women’s appraisals of their own facial and bodily attractiveness were likely weighed against various other factors we did not measure, such as women’s perceptions of their own personality and recent interpersonal successes and failures. To the extent that women’s self-evaluations of their attractiveness included their perceptions of their character and social behaviors, the moderate correlation coefficient between friends’ self-ratings might represent, in some part, similarity between friends in self-perceived personality and behavior. We also cannot know the specific group of women that came to mind when women read the phrase “other women your age.” Some may have thought of their closest …




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