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Personality and Individual Differences 54 (2013) 4751

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Personality and Individual Differences


journal homepage: www.elsevier.com/locate/paid

Sex differences in jealousy in response to indelity: Evaluation of demographic


moderators in a national random sample
Bettina Zengel a,, John E. Edlund b, Brad J. Sagarin a
a
b

Department of Psychology, Northern Illinois University, DeKalb, IL 60115, USA


Department of Psychology, Rochester Institute of Technology, Rochester, NY 14623, USA

a r t i c l e

i n f o

Article history:
Received 19 April 2012
Received in revised form 19 July 2012
Accepted 11 August 2012
Available online 8 September 2012
Keywords:
Indelity
Jealousy
Sex differences
Moderators

a b s t r a c t
Studies examining sex differences in jealousy have often relied on student samples and were restricted to
the evaluation of a selected few moderators. In this study, a nationally representative survey of American
households was presented with either an actual or a hypothetical indelity scenario (which appeared as
either a forced choice or as continuous measures). Signicant sex differences only emerged for forced
choice measures and not for continuous measures. Importantly, this effect appeared most strongly in participants reporting reactions to an actual indelity. We also explored a number of potential moderators of
this effect. These moderators were more inuential for the hypothetical than for the actual indelity scenario. Exploratory analysis of additional demographic variables was conducted.
2012 Elsevier Ltd. All rights reserved.

1. Introduction
From the perspective of evolutionary psychology, sex differences in jealousy are seen as a result of differential challenges
faced by ancestral men and women when confronted with possible
indelity of their mating partner (Buss, Larsen, Westen, & Semmelroth, 1992; Daly, Wilson, & Weghorst, 1982). From this perspective, ancestral men are seen as particularly vulnerable to sexual
indelity as it put them at risk of taking care of a child that was
not their own. In contrast, ancestral women had to fear the loss
of child-rearing support from a mate in case of an emotional indelity and possible abandonment by their partner. Men therefore
faced the challenge of paternal uncertainty whereas women faced
the challenge of ensuring paternal investment (Buss et al., 1992).
According to the theory, these different ancestral challenges
boosted mens jealousy in response to sexual indelity and womens jealousy in response to emotional indelity (Sagarin, 2005).
1.1. Methodological issues
Sex differences in jealousy were originally researched through a
forced choice measure that presented participants with a hypothetical indelity scenario and asked them to select which type
of indelity (sexual or emotional) would make them more dis Corresponding author. Tel.: +1 402 641 6632; fax: +1 815 753 8088.
E-mail addresses: bettina.zengel@gmail.com (B. Zengel), john.edlund@rit.edu
(J.E. Edlund), bsagarin@niu.edu (B.J. Sagarin).
0191-8869/$ - see front matter 2012 Elsevier Ltd. All rights reserved.
http://dx.doi.org/10.1016/j.paid.2012.08.001

tressed or upset (Buss et al., 1992). Across numerous studies, the


hypothesized sex differences generally emerged in which a greater
proportion of men than women choose the sexual indelity as
more distressing (Harris, 2003). However, when reactions to sexual
and emotional indelity were assessed separately on continuous
measures, the hypothesized sex difference often failed to appear
(Harris, 2002, 2003) including within a large random sample
(Green & Sabini, 2006). This failure, along with several other weaknesses in the methodologies used to study sex differences in jealousy, were noted in Harriss (2003) critical review of the theory.
Specically, Harris criticized the heavy use of hypothetical indelity scenarios and the heavy reliance on student samples to evaluate
sex differences. Harris (2003) noted, in particular, that Harris
(2002) had failed to nd a sex difference within an adult sample
reporting their past experiences with actual indelity. However,
as discussed in Sagarin (2005), Harris (2002) did not measure participants distress, upset, or jealousy. Rather, Harris (2002) asked
participants which aspect of the indelity (sexual or emotional)
they focused on morea difference that Sagarin (2005) speculated
could have led to the failure of the sex difference to emerge.
Although the discussion about possible methodological issues
continues (DeSteno, 2010; Edlund, 2011) a recent meta-analysis
(Sagarin et al., in press) that included data from the present study
demonstrated that sex differences in jealousy are not an artifact of
the forced-choice format but also emerge using continuous measures. Nevertheless, the large variance in effect sizes synthesized
by Sagarin et al. suggest the inuence of moderators that are yet
to be explored.

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B. Zengel et al. / Personality and Individual Differences 54 (2013) 4751

1.2. Moderators

2.2. Procedure

A variety of moderators for the sex difference in jealousy have


been evaluated. Sagarin et al. (in press) focused primarily on methodological moderators such as scale length, measured emotion,
random sampling, population type, and inclusion of a force-choice
question. Other researchers have examined moderators such as age
(Tagler, 2010), previous indelity experience (Burchell & Ward,
2011; Tagler, 2010), sex drive, relationship status (Burchell &
Ward, 2011), attachment style (Burchell & Ward, 2011; Levy &
Kelly, 2010), race and social dominance (Bassett, 2005) and the
individual difference chronic jealousy (Miller & Maner, 2009).
For example, Tagler (2010) found sex differences in jealousy
only among adults who had not previously been a victim of indelity. Burchell and Ward (2011) noted that relationship status was
only a moderator for women but not for men. Additionally, Green
and Sabini (2006) found no effect for age or SES on sex differences
in jealousy.

The study consisted of a 2 (sex: male vs. female)  2 (type of


measure: forced-choice vs. continuous)  2 (type of indelity scenario: actual vs. hypothetical) between-subjects factorial design,
with participants randomly assigned to one of the four cells of
the design. However, because we anticipated that some participants assigned to an actual indelity condition would not have
personally experienced an indelity, twice the number of participants were assigned to the actual as compared to the hypothetical
indelity conditions. Of the 1697 participants who were assigned
to and willing to answer the forced-choice actual indelity questions, 912 had not experienced any indelity (53.7%) and were
therefore unable to answer the questions. Similarly, of the 1674
participants assigned and willing to answer the continuous actual
indelity questions, 878 had not experienced any indelity
(52.5%).
In the actual indelity condition participants were asked Have
you had any experiences in which someone you were romantically
involved with cheated on you? Participants who conrmed this in
the forced choice condition were then asked Which aspect of the
cheating made you more jealous? and had the choice between
The emotional aspects of the cheating and The sexual aspects of
the cheating. For the continuous measure conditions, participants
were asked to rate on a 17 scale ranging from not at all jealous
to extremely jealous (with only the two extreme scores labeled)
How jealous did you feel about the emotional aspects of your partners indelity? and How jealous did you feel about the sexual aspects of your partners indelity? The term jealous was used
rather than other emotional labels based on ndings by Becker, Sagarin, Guadagno, Millevoi, and Nicastle (2004) that sex differences
emerged for jealousy but not for anger, hurt, or disgust.
In the hypothetical condition participants were asked to Please
think of a serious committed romantic relationship that you have
had in the past, that you currently have, or that you would like
to have. Imagine that you discover that the person with whom
youve been seriously involved cheated on you (text adapted from
Buss et al., 1992). Participants in the forced choice condition were
then asked What aspect of the cheating would make you more
jealous? and had the choice between The emotional aspects of
the cheating and The sexual aspects of the cheating. For the continuous measure conditions, participants were asked to rate on the
same 17 scale as above How jealous would you feel about the
emotional aspects of your partners indelity? and How jealous
would you feel about the sexual aspects of your partners
indelity?.
Additionally, participants were asked to provide their age, if
they lived in a dual income household, their education, race, gender, if they were the head of their household, the size of their
household, the housing type, the household income, their marital
status, if they lived in a metropolitan or non-metropolitan area, if
their household had internet access, the US state they lived in,
the number of household members between the ages of 01, 2
5, 612, 1317, and 18 and above. They also provided their current
employment status.

1.3. Current study


The current study was designed to examine the sex difference
in jealousy while systematically manipulating two methodological moderators (hypothetical indelity vs. actual-experience with
indelity; continuous- vs. forced-choice measures). Furthermore,
the study addressed the limitation of most past studies on sex
differences in jealousy of relying on university-based convenience samples by including a representative sample in the US
obtained through Time-sharing Experiments for the Social Sciences (TESS).
One additional benet of obtaining a sample through TESS is
that TESS routinely collects a variety of demographic variables that
are also passed on to researchers. Although we did not have input
on which demographics were collected, this unexpected wealth of
data enabled an analysis of possible demographic moderators of
the sex difference in jealousy. Of particular theoretical interest
were the variables age, household income, marital status, and indelity experience, as these variables allowed us to replicate and extend previous ndings by Tagler (2010), Burchell and Ward (2011),
and Green and Sabini (2006). Exploratory analyses were also conducted for the additional demographic variables collected by default through TESS.

2. Materials and methods


2.1. Participants
4507 participants contributed to the TESS study. The sample
consisted of 2204 men (48.9%) and 2303 women (51.1%). Participants were predominantly Caucasian (71.1%), however, a signicant minority of African Americans (11.7%), Hispanics (11.4%)
and Bi-racial individuals (3.0%) were also represented. The remaining 2.9% of participants identied themselves as Other, NonHispanic.
There were 258 participants (5.7%) who chose not to answer
any of the indelity questions. Tests comparing these participants
to the rest of the sample across all demographics showed signicant differences for age, household size, presence of children age
1317, ethnicity, and employment status. However, the effect sizes
were small (for continuous variables g2 6 .001, for categorical variables Cramers V 6 .053). The detailed results are listed in Supplementary Material: Appendix A. For the rest of the sample, ages
ranged from 18 to 93 (M = 47.49, SD = 17.08) with 25.6% indicating
that they were single and had never been married.

3. Results
The analysis of the data was split into the main analysis of sex
differences in jealousy for the forced choice and continuous measures and the additional analysis of moderator effects. For the
forced choice measure logistic regression was used with gender
as only covariate. For the continuous measures, a mixed model ANOVA was used with the aspect of the indelity (emotional vs. sexual) as the within-subject variable and sex as the between-subjects

B. Zengel et al. / Personality and Individual Differences 54 (2013) 4751

variable. The result of interest was the interaction between sex and
indelity type (Edlund & Sagarin, 2009). However, main effects
were also reported. Categorical moderators with more than two
levels were effects coded and continuous variables were centered.
These moderators were then entered as additional covariates into
the models (along with their interactions).
3.1. Main analyses
3.1.1. Continuous measures
For continuous measures, sex differences in jealousy (as measured by the sex by indelity type interaction) were not signicant
for the actual indelity experiences, F(1, 783) = .37, p = .54, or
hypothetical indelity scenarios, F(1, 430) = 0.00, p = .99. In case
of actual indelity, the only signicant effect was the main effect
of indelity type, with sexual indelity eliciting greater jealousy
(M = 5.56, SD = 0.06) than emotional indelity (M = 5.46,
SD = 0.06), F(1, 783) = 5.77, p = .02. In the case of hypothetical indelity, both main effects were signicant. Women (M = 5.94,
SD = 0.11) reacted overall with higher jealousy ratings than men
(M = 5.34, SD = 0.11), F(1, 430) = 14.89, p < .001 (an effect that Sagarin & Guadagno, 2004, suggest is due to differential interpretation
of the upper anchor of the jealousy scale). Additionally, sexual indelity elicited higher responses (M = 5.71, SD = 0.08) than emotional indelity (M = 5.57, SD = 0.08), F(1, 430) = 7.93, p = .005.
An additional model was run that included type of scenario (actual
vs. hypothetical) as an additional variable. Once again, there was no
signicant interaction between sex and indelity type,
F(1, 1213) = 0.14, p = .71. There was also no signicant main effect
for the type of scenario, F(1, 1213) = 1.74, p = .19. However, there
was an interaction between the type of scenario and sex,
F(1, 1213) = 24.05, p = .03. Men reported slightly higher jealousy in
response to the actual (M = 5.42, SD = 0.09) as compared to the hypothetical scenario (M = 5.34, SD = 0.11), whereas women reported
higher ratings in response to the hypothetical (M = 5.94, SD = .11) as
compared to the actual indelity scenario (M = 5.60, SD = .08). This
model also showed a main effect for sex, with women (M = 5.77,
SD = .07) reporting higher jealousy than men (M = 5.38, SD = .07),
F(1, 1213) = 15.85, p < .001, as well as a main effect for indelity type,
with sexual indelity eliciting greater jealousy (M = 5.64, SD = .05)
than emotional indelity (M = 5.52, SD = .05), F(1, 1213) = 12.78,
p < .001. All other interactions were not signicant.
3.1.2. Forced choice measures
For the forced choice measures, theory-supportive sex differences emerged in response to both actual indelity experiences
and hypothetical indelity scenarios. For actual indelity, men
were 1.66 times more likely than women to select the sexual aspects of the indelity as more jealousy-provoking than the emotional
aspects,
B = .51,
.44 6 Exp(B) 6 .82,
S.E. = .16,
Wald(1) = 10.64, p = .001. 37.1% of men chose sexual indelity as
the more disturbing option compared to 26.2% of women. A similar
pattern emerged in response to the hypothetical scenario: men
were 1.50 times more likely than women to select the sexual aspects of the indelity as more jealousy-provoking, B = .41,
.45 6 Exp(B) 6 1.00, S.E. = .21, Wald(1) = 3.81, p = .05. Here 35.9%
of men but only 27.2% of women chose the sexual indelity as
the more disturbing option.
An additional model was run that included type of scenario as
an additional variable. For this model type of scenario and its interaction with sex were both not signicant (ps > .68).
3.2. Moderator analyses
Moderator analyses were conducted separately for hypothetical
indelity scenarios and actual indelity experiences for two rea-

49

sons. First, separate analyses reect the importance of the distinction between hypothetical indelity scenarios and actual indelity
experiences in this debate. Second, as shown below, patterns of
moderation differed markedly for hypothetical and actual
indelities.
As discussed above, the expected interaction pattern of sex differences in jealousy for the continuous measures did not emerge.
As the evaluation of moderators for a non-signicant interaction
was somewhat pointless, the potential moderators were not statistically evaluated. However, the trends of these variables might still
be of interest for future research and are therefore included as a list
of means and standard deviations in Supplementary Material:
Table B.1.
The moderator analyses for the forced choice measure are summarized in Supplementary Material: Table B.2. This table lists the
number of participants per subgroup as well as the results of the
logistic regressions that test each moderator. As can be seen in
Table B.2 (and as discussed above), the sex differences were stronger for actual indelity experiences as compared to hypothetical
indelity scenarios. Furthermore, the sex difference in response
to actual indelity was not moderated by any assessed demographic variables (all ps > .054). In contrast, the sex difference in
response to the hypothetical indelity scenario was moderated
by household size, the number of adult household members, the
presence of children between the age of 25, household income,
status of being the head of the household, and the ownership status of the living quarters. The nature of these moderations is discussed below (see also Table B.2).
Household size signicantly moderated the sex difference in
jealousy (B = .39, .48 6 Exp(B) 6 .96, S.E. = .18, Wald(1) = 4.95,
p = .03). For men the odds of selecting sexual over emotional indelity was 1.20 times higher with each additional household member, whereas for women the odds were .81 times lower with each
additional household member. Both of these simple effects were
not signicant (ps > .08).
Consistent with the household size effect were two other significant moderators: the presence of adults (B = .52, .36 6
Exp(B) 6 1.00, S.E. = .26, Wald(1) = 3.90, p = .048) and of children
ages 25 (B = 1.42, .07 6 Exp(B) 6 .89, S.E. = .67, Wald(1) = 4.53,
p = .03). For men the odds of selecting sexual over emotional indelity increased 1.25 times for each additional adult household
member, whereas for women the odds decreased .75 times. As before neither of the simple effects was signicant (ps > .09). A similar but more extreme pattern emerged for the number of children
between the ages of 2 and 5. For men each additional child in that
age range increased the odds of selecting sexual over emotional
indelity 3.05 times (B = 1.12, 1.02 6 Exp(B) 6 9.10, S.E. = .56,
Wald(1) = 3.99, p = .046) while the odds for women decreased .74
times. For women this decrease was not signicant (p = .40).
Household income was another signicant moderator of the sex
difference in jealousy (B = .14, .78 6 Exp(B) 6 .96, S.E. = .05,
Wald(1) = 7.33, p = .01). For men the odds of selecting sexual over
emotional indelity decreased by .99 for each additional $10 k in
household income (a non-signicant decrease, p = .87). However,
for women these odds decreased .86 times for each additional
$10 k in household income (B = .15, .80 6 Exp(B) 6 .93, S.E. = .04,
Wald(1) = 16.07, p < .001).
Ownership of living quarters was also a signicant moderator of
the observed sex difference in jealousy (v2(2) = 6.49, p = .04; for effect code representing rent: B = 1.01, 1.22 6 Exp(B) 6 6.18,
S.E. = .41, Wald(1) = 5.97, p = .02). When asked about the ownership
status of their living quarters participants were given the choice to
select own, rent, or do not pay for housing. For men renting
(compared to the grand mean of all three types of ownership status) decreased the odds of selecting sexual over emotional indelity .56 times (B = .58, .34 6 Exp(B) 6 .94, S.E. = .26, Wald(1) = 4.86,

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B. Zengel et al. / Personality and Individual Differences 54 (2013) 4751

p = .03). For women this change in ownership status increased the


odds 1.54 times but the increase was not signicant (p = .18).
When men did not pay for housing (compared to the grand mean
of the three types of ownership status) the odds of selecting sexual
over emotional indelity increased 2.10 times (B = .74,
1.06 6 Exp(B) 6 4.16, S.E. = .35, Wald(1) = 4.56, p = .03) whereas
the odds decreased non-signicantly .62 times for women
(p = .36). Recoding to allow for a comparison of owning living quarters (compared to the grand mean of all three types of ownership
status) did not reveal any signicant changes for men or women
(all ps > .46).
The last signicant moderator was the status of being (or not
being) the head of the household (v2(1) = 4.59, p = .03; B = 1.20,
1.07 6 Exp(B) 6 10.20, S.E. = .04, Wald(1) = 4.35, p = .04). When
men were the heads of household rather than not the heads of
household, the odds of selecting sexual over emotional indelity
decreased .63 times while it increased for women 2.01 times. However, both simple effects were not signicant (ps > .09).
Of the variables that were of pre-analysis theoretical interest,
age (B = .01, .99 6 Exp(B) 6 1.01, S.E. = .01, Wald(1) = 1.02, p = .31),
marital status (v2(2) = 2.15, p = .34) and indelity experience
(B = .28, .59 6 Exp(B) 6 3.00, S.E. = .42, Wald(1) = .455, p = .50) were
not signicant moderators of the sex difference in jealousy for
hypothetical scenarios. As presented above, only household income had been both identied as variable of interest pre-analysis
and was conrmed as a signicant moderator.
3.3. Additional analyses
To replicate the nding by Tagler (2010) that indelity experience moderated adult responses to hypothetical indelity scenarios (but not college student responses to hypothetical indelity
scenarios), a logistic regression was conducted with sex, age and
indelity experience as predictors to the responses for the hypothetical forced choice scenario. However, none of the interaction
effects were signicant (all ps > .34).
The possibility that the effect of household income might not
only depend on participant sex but also on participant status as
head of household was tested. However, the three-way interaction
was not signicant (p = .68).
4. Discussion
The present study was designed to examine sex differences in
jealousy in a large random sample of US residents. To address past
criticism that sex differences emerge only in response to hypothetical indelity scenarios (and not in response to actual indelity
experiences) and only when assessed using forced choice measures
(and not when assessed using continuous measures), participants
were randomly assigned to an actual versus hypothetical indelity
condition and to a forced choice versus continuous measure condition. Contrary to predictions, the expected sex difference in jealousy was not signicant for continuous measures. However, for
forced choice measures, signicant sex differences were found in
response to actual indelity experiences and marginal sex differences were found in response to hypothetical indelity scenarios.
Furthermore, this stronger relationship for actual indelity experiences was less open to moderation with demographic variables. By
contrast, several moderation effects were found in case of the
forced choice hypothetical scenario.
With respect to the non-signicant ndings for continuous
measures, Edlund and Sagarin (2009) point out that a single nonsignicant nding cannot refute the theory of evolved sex differences in jealousy. Additionally, a recent meta-analysis that includes the results of this study (Sagarin et al., in press)

demonstrates an overall signicant effect across studies using continuous measures. However, the present results were obtained
from a large representative sample with strong generalizability
and high levels of statistical power. As such, we believe these results require consideration, even in the context of Sagarin et al.s
meta-analysis. To this end, we explored some possible reasons
for the non-signicant ndings. A ceiling effect explanation had
to be ruled out as less than 60% of men and women chose the highest anchor for any of the continuous measures. One possible difference in methodology introduced in this study was the display of
only one question per screen without possibility to compare or adjust answers. Previous research that used continuous measures
(e.g., Edlund, Heider, Scherer, Farc, & Sagarin, 2006) displayed the
two questions about the emotional and sexual aspects of the indelity on the same screen. However, a follow-up study comparing
these methodologies did not produce the hypothesized decrease in
sex differences for the separate presentation of questions as compared to simultaneous questions.
In contrast to the continuous measures, the ndings for forcedchoice measures offer strong support for the theory of evolved sex
differences in jealousy. This support is particularly strong for responses to actual indelity experiencesan effect that was not
moderated by any of the demographic variables we examined. In
contrast, responses to hypothetical indelity scenarios were moderated by a number of demographic variables. These moderators
are discussed below.
4.1. Age, indelity experience and marital status
The present study offered an opportunity to attempt to replicate
prior published moderator analyses. Like Green and Sabini (2006)
age did not emerge as moderator in the present study. Of greater
theoretical importance was our attempt to replicate Tagler
(2010). Tagler found that for an adult (non-college) sample, those
who had not previously experienced indelity showed a sex difference in jealousy when presented with a hypothetical indelity scenario but those with indelity experience showed no sex
difference. Tagler interpreted these ndings as evidence against
the evolutionary psychological theory. In contrast, in the present
study, sex differences for the hypothetical scenario emerged
regardless of previous indelity experience and regardless of
whether age was also included in the model. Furthermore, in the
present study responses to actual indelity experiences produced
stronger effects than responses to hypothetical indelity scenarios.
Taken together, these ndings provide evidence inconsistent with
the naivet explanation of sex differences in jealousy offered by
Tagler (2010). Lastly, marital status did not emerge as a moderator
in the present studya result in contrast to the ndings of Burchell
and Ward (2011).
4.2. Household income and head of household status
Two demographics examined in the present study offer possible
evidence regarding whether SES moderates the sex difference in
jealousy. In the present study, household income moderated
forced-choice responses to the hypothetical indelity scenario.
Specically, although household income did not moderate mens
responses, higher household income women chose the emotional
indelity as causing greater jealousy more often than did lower
household income women. However, when women were the head
of the household they displayed an increase in jealousy in response
to sexual indelity, whereas men showed a decrease. These ndings highlight the fact that responses to indelity differ not only
by sexthey also differ importantly by individual social status
at least when considering the hypothetical possibility of indelity.
In particular, these ndings might reect female mating strategies,

B. Zengel et al. / Personality and Individual Differences 54 (2013) 4751

with high household income women more willing to turn a blind


eye toward their husbands sexual indelity but on guard against
the possibility that his affections are being channeled elsewhere.
Further insight into this possibility could be gained by comparing
high household income women whose income is self-generated
with high household income women whose income comes from
their husband.
4.3. Household size
Two aspects of household size (the number of children ages 25
and the number of adult household members) moderated responses to indelity. It seems plausible that women who are caring
for young children might be at particular risk should their partner
withdraw resources after becoming emotionally attached to a rival.
Consistent with this, the number of children ages 25 moderated
the sex difference in jealousy, with men showing a greater tendency to select the sexual indelity and women showing a greater
tendency to select the emotional indelity as the number of young
children increased. However, somewhat inconsistent with this
explanation were similar patterns that emerged for the number
of adult household members and the fact that the simple effect
for women was non-signicant. Nevertheless, household size and
constituents may represent fruitful directions for future research.
5. Conclusion
Since its inception, the theory of evolved sex differences in jealousy has inspired numerous studies and provoked intense debate.
The present study helps to forward this debate in a number of
ways. First, it offers an unusually strong level of generalizability
stemming from its national representative sample. Second, it offers
the strongest evidence to date that the sex difference in jealousy
appears not only in response to hypothetical indelity scenarios
but also in response to actual indelity experiences. Third, it offers
evidence regarding a number of demographic moderators, some
replicating (or notably not replicating) prior investigations, others
suggesting potentially fruitful directions for future theory development and research. Our study will certainly not close the debate
(and, indeed, our continuous measure results provide evidence
arguably favorable to opponents of the theory), but we hope it will
help to move the debate forward.
Acknowledgements
Data collected by Time-sharing Experiments for the Social Sciences, NSF Grant 0818839, Jeremy Freese and Penny Visser, Principal Investigators.

51

Appendix A. Supplementary data


Supplementary data associated with this article can be found, in
the online version, at http://dx.doi.org/10.1016/j.paid.2012.08.001.
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