A 25-Year Review of Nighttime Fears in Children: Past, Present, and Future

Abstract

Nighttime fears in children are common, interfere with daily functioning, and result in considerable disruption in the family. The aim of the present review was to examine empirical literature from the past 25 years that investigated the assessment of nighttime fears in young children and the efficacy and effectiveness of psychosocial treatments for children's nighttime fears. The last review of this literature was in 1997 and examined studies conducted in and prior to 1995 (King et al. in Clin Psychol Rev 17:431–443, 1997). Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted a systematic review of the literature aimed at providing a synthesis of the Randomized Control Trials (RCTs) and controlled single-case multiple baseline design studies (MBLs) on the treatment of nighttime fears in children. A search of the literature identified 12 articles, with nine studies utilizing a between-group randomized controlled trial design and three studies utilizing a multiple baseline design. Results demonstrated significant improvements in children’s nighttime fears and reductions in disruptive nighttime behaviors using behavioral interventions and cognitive-behavioral strategies. This review provides a commentary on the effectiveness and limitations of the assessment and treatment approaches for nighttime fears in children and suggests directions for future research.

Full text

Vol.:(0123456789)
1 3
Clinical Child and Family Psychology Review (2021) 24:391–413
https://doi.org/10.1007/s10567-021-00354-4
A 25‑Year Review ofNighttime Fears inChildren: Past, Present,
andFuture
KrystalM.Lewis1 · RenathaElRahi‑Ferreira2· GabrielleF.Freitag3· MaryComan4· ThomasH.Ollendick5
Accepted: 25 May 2021 / Published online: 14 June 2021
© This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply 2021
Abstract
Nighttime fears in children are common, interfere with daily functioning, and result in considerable disruption in the family.
The aim of the present review was to examine empirical literature from the past 25years that investigated the assessment of
nighttime fears in young children and the efficacy and effectiveness of psychosocial treatments for children’s nighttime fears.
The last review of this literature was in 1997 and examined studies conducted in and prior to 1995 (King etal. in Clin Psychol
Rev 17:431–443, 1997). Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guide-
lines, we conducted a systematic review of the literature aimed at providing a synthesis of the Randomized Control Trials
(RCTs) and controlled single-case multiple baseline design studies (MBLs) on the treatment of nighttime fears in children. A
search of the literature identified 12 articles, with nine studies utilizing a between-group randomized controlled trial design
and three studies utilizing a multiple baseline design. Results demonstrated significant improvements in children’s nighttime
fears and reductions in disruptive nighttime behaviors using behavioral interventions and cognitive-behavioral strategies.
This review provides a commentary on the effectiveness and limitations of the assessment and treatment approaches for
nighttime fears in children and suggests directions for future research.
Keywords Nighttime fears· Children· Dark phobia· Treatment· Assessment
Introduction
Nighttime fears in young children are common, as many
researchers have documented a developmental progression
of normal fears from early childhood into adolescence (Fer-
arri, 1986; Gullone, 2000; Muris etal., 2001). These fears
generally dissolve across development; however, for a signif-
icant number of children, nighttime fears persist and become
pathological (Bauer, 1976; Warren & Sroufe, 2004). Not
only may these fears persist into adolescence, but they can
also have adverse effects on child development, leading to
later anxiety and other diverse forms of child psychopathol-
ogy (Bittner etal., 2007). Indeed, fear of the dark or sleeping
alone constitutes one of the 10 most common fears in chil-
dren between seven and 10years of age (Canals etal., 2019;
Muris etal., 2001). Common fears can extend beyond fear
of being in the dark alone to fear of scary creatures or to bad
things happening at night, and such core fears can change
across development (Muris etal., 2001). Research with non-
clinical samples suggests that 73.3% of children and adoles-
cents report nighttime fears with rates varying depending on
developmental period (Muris etal., 2001). Within clinical
populations, up to 20–30% of children have severe, debili-
tating nighttime fears and sleep difficulties (Bauer, 1976;
Gordon, 2004; Gordon etal., 2007a; Ollendick & Muris,
2015; Sadeh, 2005). Furthermore, up to 15% of referrals for
the treatment of childhood phobias are related to the dark
* Krystal M. Lewis
krystal.lewis@nih.gov
1 National Institute ofMental Health, 9000 Rockville Pike, 10
Center Drive, Bldg.10 RM B1D43S, Bethesda, MD20814,
USA
2 Institute ofPsychiatry, Hospital da Clinicas - Faculty
ofMedicine, University ofSao Paulo, 785 Ovídio Pires de
Campos, SãoPaulo, SP05403903, Brazil
3 Department ofPsychology, Center forChildren andFamilies,
Florida International University, 11200 SW 8th Street,
Miami, FL33199, USA
4 Rochester, MN, USA
5 Department ofPsychology, Child Study Center, Virginia
Polytechnic Institute andState University, Blacksburg,
VA24060, USA
Content courtesy of Springer Nature, terms of use apply. Rights reserved.