The Relationship Between Pretend Play Processes and Anxiety

The current research was designed to examine how pretend play is related to anxiety. This relationship with pretend play needs more investigation in order to be able to assess and identify those with anxiety. This is important because pretend play could be used as an intervention to reduce anxiety. It was hypothesized that pretend play is correlated with anxiety; if a child has better pretend play skills, parents are more likely to rate their child’s anxiety lower than parents of children with poorer pretend play skills. The current study examined cognitive and affective play processes, which include organization, imagination, comfort with the play, and frequency and variety of affect expression. Cognitive and affective play processes were used to test the relationship with anxiety. The participants were 15 preschool-aged children. Measurements for anxiety were done by parental report with the BASC-2 and play was measured with APS-P. It was hypothesized that pretend play would correlate with parent-report of their child’s anxiety; the better the play skills, the lower the anxiety. Based on previous research of gender differences in anxiety indicating that females are more anxious, it was predicted that females would be rated as more anxious than males. Correlations were analyzed to examine the relationship between play and anxiety. T-tests were conducted to examine gender differences. No significant correlations were found between pretend play and anxiety. There was no significant difference between anxiety in males and females. Although no correlations were found between pretend play and anxiety and gender differences in anxiety were not found, further research needs to be done due to this study having a small sample size. This was the first study that examined the relationships between pretend play and anxiety in preschool aged children. Therefore, a larger sample size is needed before conclusions can be drawn and recommendations for further research are discussed. Running head: PRETEND PLAY AND ANXIETY 3 The Relationship between Pretend Play Processes and Anxiety Many researchers have found that play is correlated with coping (Russ, 2004). It is believed that children use play as a way to solve problems within their lives (Russ, 2004). According to Russ, play stimulates emotion because children are pretending, which allows them to feel a full range of emotions. Both affective and cognitive pretend play processes have been found to relate to emotion regulation and expression (Christian, Russ, & Short, 2011). With affect expression in pretend play, children learn how to act out their negative emotions by coping and learning problem solving skills. They find creative ways to solve their problems that can apply to other areas in their life. For example, more frequency and variety of affect expression in the child’s play relate to better coping skills (Christian, Russ, & Short, 2011). This supports the theory that affective play processes relate to coping, which in turn could relate to reducing anxiety. Children who engage in good pretend play typically have more developed coping abilities. In addition to affect expression in play, better imagination, organization, and comfort in play correlates with coping. Russ (1988) conducted a study where she found a relationship between divergent thinking and teachers ratings of fifth grade males. The more creative the problem solving skills were during pretend play, the more they should generalize to problem solving skills in their daily lives. Therefore, more imagination used during play correlated with better coping. Christiano and Russ (1996) later found a positive relationship between play and coping and a negative relationship between play and distress in 7 to 9 year olds. Perry and Russ (1998) found that fantasy in pretend play related to frequency and variety of self-reported coping strategies. The coping measure was self-reported by school aged children housed in a homeless Running head: PRETEND PLAY AND ANXIETY 4 shelter. Children who demonstrated good fantasy skills reported greater frequency and variety of coping strategies when faced with stressful situations (Perry & Russ, 1998). Therefore, more imagination correlated with better coping abilities. Later, Goldstein and Russ (2000-2001) conducted a study on first grade children. They found a positive correlation between the Affect in Play Scale (APS) imagination score, a standard measure that assesses cognitive and affective processes in school aged children, and children’s self-report on how well they would be able to cope with a specific situation. The imagination score related to total frequency and variety of coping strategies. All together these coping studies used different samples of children, had different researchers, and different measurements for coping. A variety of scores on the APS scale were correlated with coping, indicating that both cognitive and affect play processes relate to coping abilities. Previous research has also found that pretend play relates to anxiety. Christian et al. (2011) conducted a study where first to third grade children were assigned to an anxious mood induction condition or a neutral mood induction condition. They found that children with a greater baseline of state anxiety had less organization in their play narrative. Therefore, the more anxious the child was, the less organization was in their play. Christian et al. (2011) also found that positive affect expressed during play was related to the relationship between the level of self-reported state anxiety and condition assignment. Children in the anxious mood induction condition reported that their mood returned to a neutral or positive state after they participated in play. This suggests that pretend play can increase positive affect when children are feeling anxious. Overall, Christian et al. (2011) suggested that pretend play therapies may be useful for those with anxiety to cope. Likewise, Moore and Russ (2008) also found that play interventions were effective in reducing anxiety in typically-developing school aged children. Running head: PRETEND PLAY AND ANXIETY 5 Similarly, Malcom Watson found that anxiety was related to pretend play in children (1995). Watson argues that pretend play becomes more complex when it involves social interaction and collaboration. To support this theory, Watson (1995) conducted a study where he assigned children to a free-play or story condition. He found that highly anxious children in the free-play condition showed a greater decrease in anxiety than the children in the story condition. This supports the theory that play correlates with anxiety. He also found that highly anxious children expressed more pretend play than manipulative or functional play. This supports the theory that anxiety is correlated with specific pretend play processes. However, Watson found that highly anxious children participated more in pretend play during situational anxiety. Watson also found that pretend play was preferred after an anxiety-provoking situation. Children participated in play to express their emotions and cope with the stressful situation. This supports the theory that the use of pretend play is related to anxiety reduction and coping skills. Evidence of anxiety correlating with pretend play supports the use of pretend play as an approach to psychotherapy. Based on psychodynamic theory, children use pretend play to control their negative emotions such as anxiety (Russell & Jarvis, 2003). Play therapies are proposed to work due to the gradual exposure and extinction of their anxiety. Pretend play also allows children to express their anxiety and cope better with stressful experiences. For example, Fonagy and Target (1994) conducted a study of 800 children being treated for anxiety and depression in a clinical setting where all received treatment. Most treatments took up to 2 years and about 80% of the children were almost free of their symptoms after play therapy. Burns-Nader (2011) also found that pretend play in a medical setting correlated with anxiety reduction in young patients. Even though there is research to support that anxiety is correlated with pretend play skills in school-aged children, there needs to be more research examining these relationships in Running head: PRETEND PLAY AND ANXIETY 6 preschool-aged children. Furthermore, previous research has not looked at pretend play processes separately in this age range. Specifically, the relationships between imagination, organization, comfort in play, variety and frequency of affect and anxiety in preschool aged children need to be examined. Hypotheses 1. It was hypothesized that pretend play would correlate with parent-report of their child’s anxiety; the better the play skills, the lower the anxiety. 2. It was hypothesized that both cognitive and affective play processes would relate to anxiety. Better organization, imagination, and comfort with play would correlate with anxiety. More frequency and variety of affect expression would correlate with anxiety as well. 3. Based on previous research of gender differences in anxiety indicating that females are more anxious, it was predicted that females would be rated as more anxious than males. However, it was hypothesized that pretend play processes would remain correlated with anxiety levels in both genders.