"The only thing we have to fear is fear itself," President
Franklin Roosevelt declared.
Yet it's unlikely that many youngsters would agree with him, suggests a new
study conducted by Australian and American researchers and published in the
October Behavior Research and Therapy. They have found that
youngsters' nighttime fears have an astonishing number of causes.
The investigators studied the sources of nighttime fears in a large,
school-based sample of children and adolescents in Australia—511 youth
aged 8 to 16 from various socioeconomic backgrounds. The youngsters indicated
that they had experienced nighttime fears due to 34 different causes. The most
common causes were, in order, noises inside or outside the house, an imagined
intruder, scary dreams, darkness, imaginary creatures, the security of family
or friends, animals, and worry about the day's events.
The senior investigator, Thomas Ollendick, Ph.D., director of the Child
Study Center at Virginia Tech, told Psychiatric News that he wasn't
surprised by these findings because a Dutch study of 176 children aged 4 to 12
produced similar results. But a result from the Australian study that did
surprise him, Ollendick said, was the large percentage of youngsters—64
percent—who experienced nighttime fears either frequently or
occasionally. "We anticipated that it would be more around a
third," Ollendick said.
The study also revealed that significantly more children than adolescents,
and more females than males, experienced nighttime fears often or
The study likewise showed that whereas children were more prone to certain
types of fears than adolescents were, adolescents were also more prone to
certain types of fears than children were. Still other types of fears were
equally prevalent in both groups.
For example, children were more likely to be afraid of scary dreams or
fantasy creatures, while adolescents were more likely to be disturbed by
troubling thoughts. Yet other sources of angst—noises inside or outside
the house, darkness, and the security of family and friends—were equally
prevalent among both children and adolescents.
The youngsters in the study were asked what strategies they used to cope
with their nighttime fears. Their two most common strategies were trying to
ignore their worries and thinking about something else or going to their
parents and talking to them about their worries. Strategies they used less
often included turning on a light, clinging to a stuffed animal, asking their
parents for a drink, or praying.
Finally, the parents of the youngsters who participated in the study were
asked how often they thought their offspring had nighttime fears. They
dramatically underestimated what the youngsters themselves reported.
The study results have "tremendous implications" for child and
adolescent psychiatrists, Ollendick believes. For example, although the
youngsters who participated in the study came from the community, not from a
clinical sample, nighttime fears in about 10 percent were related to one or
more anxiety disorders as defined by DSM criteria. Separation anxiety
was the most common.
"Child and adolescent psychiatrists need to be aware that nighttime
fears may be frequent, severe, and of long duration for some children,"
Jocelynne Gordon, Ph.D., of Monash University in Victoria, Australia, and lead
study investigator, added. "A DSM-based assessment for specific
phobia and other anxiety disorders may be indicated. Medical assessments for
child sleep disturbances also need to include questions about the child's
anxiety and fear experienced at night."
Gordon, Ollendick, and their group will now be looking at nighttime fears
across different cultures and will attempt to determine whether co-sleeping
protects against such fears or leads to more of them. Co-sleeping is commonly
understood as a child sleeping with his or her parents for an extended period
of time, sometimes until ages 5, 7, or even 9.
Although it is generally frowned upon in the United States, it is common in
countries such as China, Italy, Japan, Spain, and Sweden.
The researchers are also trying to get a randomized controlled trial under
way to see whether treating nighttime fears in children without diagnosable
anxiety disorders can prevent the onset of such disorders.
Yet only a longitudinal study, the researchers pointed out, would
demonstrate whether nighttime fears in youngsters predict the later
development of anxiety disorders.
An abstract of "Nighttime Fears of Children and Adolescents:
Frequency, Content, Severity, Harm Expectations, Disclosure, and Coping
Behaviors" can be accessed at<www.sciencedirect.com>
by clicking on "Browse by title," then "B," then"
Behavior Research and Therapy." ▪