From monsters under the bed to bogeymen in the closet, most children experience nighttime fears.
While most grow out of them on their own, for some children, there's a risk of developing anxiety problems later in life, according to new research.
In the new study, researchers at Tel Aviv University discovered that preschoolers with persistent nighttime fears were far less able to distinguish reality from fantasy compared to their peers.
To test their hypothesis that fantasy-reality confusion has a strong impact on nighttime fears, researchers evaluated children between the ages of 4 and 6. Out of the group, 80 who were diagnosed with severe nighttime fears and 32 with more normal development.
The children were evaluated on their ability to separate fact from fiction based on parental reports and a standardized interview. For example, the researchers presented the children with the character of a fairy, then asked a series of questions to determine whether or not the fairy was fictional, including whether or not they could call the fairy by phone or the fairy could visit them at home.
Children with more intense nighttime fears were significantly less able to differentiate reality from fantasy, according to the researchers. Younger children also scored lower on these evaluations, a result attributable to the children's developmental stage, the researchers explained, noting the lower the score, the more severe the child's nighttime fears.
According to Avi Sadeh of Tel Aviv University's School of Psychological Sciences, the fantasy-reality confusion that causes nighttime fears can also be used to help children to overcome these fears by tapping into their imaginations.
"We send children mixed signals by telling them that monsters aren't real while we tell them stories about the tooth fairy," he said.
Simply telling a child that their fear isn't realistic doesn't solve the problem, he added.
Instead, he recommends using the child's strong imagination as a treatment tool. For instance, parents might help their children view an imaginary monster as a non-threatening entity, perhaps by writing it a letter to extend an offer of friendship or reading the child a book in which a threatening figure turns out to be friendly.
One treatment that Sadeh has found highly effective is a toy called a "huggy puppy." In this therapy, children are presented with a stuffed dog and told that the once happy puppy is now sad. They are given the responsibility of being the puppy's friend, caring for him, and ensuring that he is not afraid at night.
Because this intervention depends on the child's willingness to believe the puppy's story and embrace their new compassionate role, it works best for children with stronger imaginations, he said.
The study was published in Child Psychiatry and Human Development.
Source: Tel Aviv University--Courtesy of PsychCentral