Nighttime fears of children and adolescents: frequency, content, severity, harm expectations, disclosure, and coping behaviours

The present school-based study investigated the nighttime fears of 511 children and adolescents, aged 8-16 years. Participants were assessed using a structured interview about the frequency, content, severity, harm expectations, coping strategies, and disclosure of nighttime fears. Results indicated that nighttime fears are a common experience, with nearly two-thirds (64.2%) of children and adolescents reporting nighttime fears. Fear of intruders/home invasion was the most frequently reported nighttime fear. Females more frequently reported nighttime fears than males (72.9% and 54.6%, respectively) and a greater number of children reported nighttime fears compared to adolescents (79.4% and 48.8%, respectively). Nighttime fears were given moderate severity ratings, and harm expectations were most strongly associated with 'personal security' fears. Respondents reported a variety of coping strategies to manage their nighttime fears with self-control/distraction techniques being the most common. Most respondents reported disclosing their nighttime fear(s) to another person. The clinical implications of these findings and the methodological limitations are discussed.     

Anxiety in Swedish School Children: Situational Specificity,Informant Variability and Coping Strategies

In a school sample, 463 Swedish children aged between 8 and 12 years reported their experience of anxiety during 11 "typical" home and school setting activities. In addition to rating the frequency and type of anxiety experienced, the children reported whether they used coping strategies to reduce their anxiety. Parents and teachers also rated the anxiety levels in the same children. Nine percent of the children reported that they experienced anxiety "often" during at least 1 of the 11 home and school activities and 1.5% reported an anxiety level of "often" averaged across all of the 11 activities. The parents reported that 9% of the children experienced "moderate" to "very much" anxiety levels averaged across the home-related activities, whereas the teachers reported that 38.5% of the children had such anxiety levels at school. Overall, the children's ratings of their frequency levels of anxiety were found to depend more on age than on gender. The children and their parents both regarded anxiety to be most common during "leaving home for school" and "going to bed at night" activities. The correspondence between child, parent and teacher reports of overall anxiety in the children was low; similar findings were obtained for anxiety among children in the various setting activities. The 8-year-old children reported a higher use of various coping strategies than did the 12-year-olds. The results are discussed in view of the current literature on anxiety and fears in children.     

Fears, worries, and scary dreams in 4- to 12-year-old children: their content, developmental pattern, and origins

Investigated anxiety symptoms in normal school children 4 to 12 years of age (N = 190). The percentages of children reporting fears, worries, and scary dreams were 75.8, 67.4, and 80.5%, respectively, indicating that these anxiety symptoms are quite common among children. Inspection of the developmental pattern of these phenomena revealed that fears and scary dreams were common among 4- to 6-year-olds, became even more prominent in 7- to 9-year-olds, and then decreased in frequency in 10- to 12-year-olds. The developmental course of worry deviated from this pattern. This phenomenon was clearly more prevalent in older children (i.e., 7- to 12-year-olds) than in younger children. Furthermore, although the frequency of certain types of fears, worries, and dreams were found to change across age groups (e.g., the prevalence of fears and scary dreams pertaining to imaginary creatures decreased with age, whereas worry about test performance increased with age), the top intense fears, worries, and scary dreams remained relatively unchanged across age levels. An examination of the origins of these common anxiety phenomena showed that for fears and scary dreams, information was the most commonly reported pathway, whereas for worry, conditioning experiences were more prominent.     

A factor analytic investigation of children's nighttime fear and coping responses

Checklists of children's nighttime fears and nighttime coping responses, completed by 178 8- to 13-year-old children and one of their parents, were factor analyzed. The resulting factors from each checklist were comparable for children and parents. The nighttime fear categories consisted of content around security either for one's personal life, loss, or safety or for others' safety and continued presence; imaginal-numinous concerns; and characteristics inherent in a nighttime situation. The coping categories consisted of responses related to internal self-control, social support, support from inanimate objects, prayer, and avoidance or escape either by controlling the inanimate environment or by controlling others.     

Parent-directed cognitive behavioral therapy for young anxious children: a pilot study

Anxiety in children age 8 years and above has been successfully treated with cognitive behavioral therapy (CBT). However, the efficacy of CBT for anxious children ages 4-7 years has not, to date, been fully investigated. This paper piloted a CBT intervention targeting child anxiety that was delivered exclusively to parents of 26 children with anxiety symptoms ages 4-7 years. The intervention consisted of four 2-hour group sessions of four to six parents (couples). These group sessions were followed by four individual telephone sessions, once per week across a 4-week period. The pre- and postintervention assessment involved measures of multiple constructs of child anxiety (anxiety symptoms, children's fears, behavioral inhibition, and internalizing symptoms) from multiple informants (parents, children, and teachers). Parents also reported parenting strategies they were likely to use to manage their children's anxiety pre- and postintervention. Results indicated a significant decrease in child anxiety and behavioral inhibition as reported by parents and teachers. Furthermore, mothers reported significant increases in their use of positive reinforcement, and modeling and reassurance, and a significant decrease in their use of reinforcement of dependency directly after treatment. Taken together, parent-directed CBT appears to be an effective approach for treating children ages 4-7 years with anxiety symptoms. Limitations of the current research are discussed.     

Responses of preschoolers in two frustrating episodes: emergence of complex strategies for emotion regulation

Although research on young children's abilities to organize emotional states has increased in recent years, little is known about the emergence of complex strategies for emotion regulation in preschoolers. In the present study, emotion-regulation strategies used by 52 normally developing 3- and 4-year-olds were examined. Children and their primary caregivers (50 mothers, 2 fathers) participated in 2 controlled frustration episodes that were videotaped. Four types of strategies were coded: comforting behaviors, instrumental behaviors, distraction behaviors, and cognitive reappraisals. Results indicated that 3-year-olds used proportionately more instrumental strategies than 4-year-olds, and parents of 3-year-olds showed the same pattern, whereas parents of 4-year-olds did not. Moreover, 3-year-olds used a variety of strategies when frustrated, including cognitive reappraisals. Significant positive correlations were found between the types of strategies used by the children and by the parents to help their children. It is suggested that children may be using strategies to organize their emotional states before they are able to accurately report on them.     

Fears and related anxieties across three age groups of Mexican American and White children with disabilities

The authors compared levels and types of fears and anxieties in a sample of Mexican American children and adolescents with disabilities to a group of White children and adolescents with similar disabilities. Students (N = 238), parents, and teachers completed the Fear Survey Schedule for Children-Revised (T. H. Ollendick, 1983) and the Revised Children's Manifest Anxiety Scale (C. R. Reynolds & B. O. Richmond, 1997). Levels of fear and anxiety were similar for both groups of students and were similarly underestimated by teachers. The groups of students differed in terms of their specific fears and the degree to which their parents recognized their children's fears (Mexican American parents were less accurate at rating their children's fears). Mexican American girls aged 7-10 and 11-13 years and White girls aged 14-18 years reported the highest scores; White boys aged 14-18 years reported the lowest scores.     

Prevention of anxiety symptoms in children: results from a universal school-based trial

The present study evaluated the effectiveness of a universal school-based cognitive behavior prevention program (the FRIENDS program) for childhood anxiety. Participants were 638 children, ages 9 to 12 years, from 14 schools in North Rhine-Westphalia, Germany. All the children completed standardized measures of anxiety and depression, social and adaptive functioning, coping strategies, social skills, and perfectionism before and after the 10-week FRIENDS program and at two follow-up assessments (6 and 12 months) or wait period. Children who participated in the FRIENDS program exhibited significantly fewer anxiety and depressive symptoms, and lower perfectionism scores than children in the control group at 12-month follow-up. Younger children (9-10-year-olds) displayed treatment gains immediately after the intervention, whereas older children (11-12-year-olds) showed anxiety reduction only at 6- and 12-month follow-up. Perfectionism and avoidant coping acted as mediators of pre- to postintervention changes in anxiety scores. This study provides empirical evidence for the utility of the FRIENDS program in reducing anxiety and depressive symptoms among German children.     

Stress,coping, and adjustment in mothers and young adolescents in single- and two-parent families

Compared stress, coping, and psychological adjustment in single (divorced or separated) and married mothers and their young adolescent children. Single mothers reported more daily hassles related to economic, family, and personal health problems, and more symptoms of depression, anxiety, and psychoticism. Single mothers also reported using more coping strategies related to accepting responsibility and positive reappraisal. After controlling for level of family income, differences in family hassles and coping strategies remained significant. The two groups did not differ on subtypes of symptoms after controlling for income, but single mothers still reported more total psychological symptoms. No differences were found between children in these two family constellations on maternal reports of emotional/behavioral problems or on children's self-reported emotional/behavioral problems, stressful events, or coping. Implications of these findings for adjustment to life in single-parent families are discussed.     

Remembering children's emotions: sources of concordant and discordant accounts between parents and children.

Parents were asked to recall recent events that had evoked happiness, sadness, anger, and fear in their children. Children (N = 77, 2.3-6.6 years) indicated whether they remembered each event, and if so, they described the event and how it had made them feel. Agreement between parent and child concerning how the child felt varied as a function of emotion. Children agreed with their parents' emotion attributions most often for events that parents recalled as having evoked happiness and sadness, less often for fear, and least often for anger. Children disagreed with parents' attributions of happiness and sadness most often when parents and children differed concerning the attribution of children's goals. Discordant reports about children's anger were most frequent when parents and children reported conflicting goals. Discordant reports about fear were most frequent when parents and children focused on different parts of the temporal sequence surrounding the event.     

School Aged Children’s Experiences 7 and 13 Months Following a Sibling’s Death

This study described 6-year to 12-year-old children’s responses 7 and 13 months after siblings’ NICU/PICU/ED death. Using semi-structured interviews, at 7 months, children were asked about events around their sibling’s death. At both 7 and 13 months, children were asked about their thoughts and feelings about the deceased, concerns or fears, and life changes since the death. Thirty one children (58% female), recruited from four South Florida hospitals and Florida obituaries, participated. Children’s mean age was 8.4 years; 64.5% were Black, 22.5% Hispanic, 13% White. Interviews were analyzed using conventional content analysis. Resulting themes: circumstances of the death, burial events, thinking about and talking to the deceased sibling, fears, and life changes. Most children knew their sibling’s cause of death, attended funeral/memorials, thought about and talked to their deceased sibling, reported changes in family and themselves over the 13 months. Fears (something happening to themselves, parents, other siblings—death, cancer, being snatched away) decreased from 7 to 13 months especially in 7-year to 9-year-olds. Seven-year to 9-year-olds reported the greatest change in themselves from 7 to 13 months. More Black children and girls thought about the deceased and reported more changes in themselves over the 13 months. School aged children thought about and talked with their deceased sibling, reported changes in themselves and their family and their fears decreased over the first 13 months after their sibling’s death     

Responses of Preschoolers in Two Frustrating Episodes: Emergence of Complex Strategies for Emotion Regulation

Although research on young children's abilities to organize emotional states has increased in recent years, little is known about the emergence of complex strategies for emotion regulation in preschoolers. In the present study, emotion-regulation strategies used by 52 normally developing 3- and 4-year-olds were examined. Children and their primary caregivers (50 mothers, 2 fathers) participated in 2 controlled frustration episodes that were videotaped. Four types of strategies were coded: comforting behaviors, instrumental behaviors, distraction behaviors, and cognitive reappraisals. Results indicated that 3-year-olds used proportionately more instrumental strategies than 4-year-olds, and parents of 3-year-olds showed the same pattern, whereas parents of 4-year-olds did not. Moreover, 3-year-olds used a variety of strategies when frustrated, including cognitive reappraisals. Significant positive correlations were found between the types of strategies used by the children and by the parents to help their children. It is suggested that children may be using strategies to organize their emotional states before they are able to accurately report on them.     

Coping skills training for children: effects on distress before, during, and after hospitalization for surgery

Thirty-three parent-child dyads (children's mean age = 7.2 years, SD = 1.2) were randomly assigned to information, anxiety reduction, or coping skills presurgical preparatory interventions. All groups received the "information" procedure that described typical hospitalization and surgery experiences via a puppetry film viewed 1 week prior to hospital admission. In the anxiety reduction group, parents also learned procedures (e.g., relaxation) to help them reduce their own distress. Parents in the coping skills group learned how to help their children use coping self-talk and related techniques. The coping skills intervention was expected to assist children most effectively, although the anxiety reduction procedure was also expected to improve adaptation relative to the information condition. These hypotheses were generally supported. Anxiety reduction and coping skills groups, compared to the information group, reduced children's self-reported fearfulness and parents' reported distress. Furthermore, only the coping skills group, compared to the information group, exhibited fewer maladaptive behaviors during hospitalization (ratings by observers) and less problematic behavior in the preadmission week and second postdischarge week (daily parental diaries). Theoretical explanations for these results are discussed in light of the similar findings obtained by Peterson and Shigetomi (1981).     

How serious are common childhood fears? II. The parent's point of view

In an earlier study [Muris, P., Merckelbach, H., Mayer, B., & Prins, E. (1999). How serious are common childhood fears? Behaviour Research and Therapy, in press.], the severity of common childhood fears was explored by means of a structured child interview measuring specific phobias as defined by the Diagnostic and Statistical Manual of Mental Disorders. It was found that in a substantial minority of the children, specific fears reflect clinically significant phobias. The present study examined further the connection between childhood fears and specific phobias by interviewing children's parents. The Diagnostic Interview Schedule for Children was administered to the parents of 160 children aged 4-12 years. In line with our previous study, results indicate that a sizable proportion of children (i.e. 17.6%) met the full criteria for specific phobia.     

Reducing child witnesses' false reports of misinformation from parents.

This study explored whether a source-monitoring training (SMT) procedure, in which children distinguished between events they recently witnessed versus events they only heard described, would help 3- to 8-year-olds to report only experienced events during a target interview. Children (N = 132) who witnessed science demonstrations and subsequently heard their parents describe nonexperienced events received SMT before or after a forensic-style interview. SMT reduced the number of false reports that 7- and 8-year-old children reported in response to direct questions but had no impact on the performance of younger children. Combined with earlier results, these data suggest a transition between 3 and 8 years of age in the strategic use of source-monitoring information to support verbal reports, such that only 7- and 8-year-olds generalize training to a difficult memory task that does not include mention of specific alternative sources.     

Family influences on dysfunctional thinking in anxious children

Anxious children are found to interpret ambiguous stories in a negative way. The current study attempted to examine the possible influence of parental fear and parental interpretation bias on the maintenance of such an interpretation bias. Children varying in level of anxiety (n=25) and their parents, filled in a questionnaire to measure their own fears, and gave their interpretations concerning nine ambiguous stories, relevant for childhood ‘interactional’ anxieties: social anxiety, separation anxiety, and generalized anxiety. Then, parents were asked to talk with their children about three of the stories. After the family discussion the children had to give their final interpretations. Results indicated that parents' self‐reported fear level and interpretation bias were associated with children's interpretation bias before the family discussion. However, no evidence was found for the idea that parents maintain or enhance the interpretation bias of their children. That is, irrespective of parental fear and parental interpretation bias, children interpreted the ambiguous stories as less negative after discussing them with their parents. Copyright © 2003 John Wiley & Sons, Ltd.     

Differences and similarities between children,mothers, and teachers as informants on disruptive child behavior

Prevalence rates of disruptive child behaviors, based on structured psychiatric interviews, are presented for samples of clinic-referred prepubertal boys at two sites to investigate differences and similarities among reports of the behaviors from children, parents, and teachers. Children reported significantly less hyperactive/inattentive and oppositional behaviors than either parents or teachers. In contrast, children did not differ from parents or teachers in their report on the prevalence of more serious conduct problems. These results were well replicated across two sites, despite the fact that there were significant differences between the sites in the level of hyperactive/inattentive child behaviors and conduct problems. The ranking of parents' and teachers' reported prevalence of specific child behavior problems in each of the three domains of disruptive behavior was strikingly similar. With one exception, the concordance between the prevalence ranking based on the children's reports was lower than that based on adults' reports, Children's reports on their own behavior did not predict various child handicaps 1 year later as well as did adults' reports. The results are discussed in relation to the usefulness of certain child behaviors in symptom lists for diagnostic purposes; the reliability of children's reports on their own behavior; and the possible reasons why prevalence rankings, as perceived by adults, are so similar.     

Marital Quality, Family Patterns, and Children's Fears and Social Anxiety

This study examined relationships among marital quality, family patterns, and children's fears, and social anxiety. Two types of family patterns were studied, adaptability and cohesion. Mothers of children aged 5–6, drawn from kindergartens in northern Israel, completed Hebrew versions of the ENRICH scale (abridged, for marital quality), FACES-III (adaptability and cohesion), the FSSC-R (fears), and the SASC-R (social anxiety). Family cohesion was negatively correlated with marital quality and positively correlated with children's social anxiety. Marital quality and family adaptability were inversely related to specific children's fears. Children's social anxiety was highly correlated with specific fears. These findings suggest that children from rigid, fused families or low quality marriages may be at risk for high levels of fears and social anxiety.     

Reducing Parent Distress and Increasing Parent Coping-Promoting Behavior During Children's Medical Procedure

The study investigated whether involving parents in their child's cognitive-behavioral intervention would effectively reduce parent distress during their child's medical procedure. Parents participating with their 3- to 7-year-old children prior to a voiding cystourethrogram were randomly assigned to an intervention (N = 20) or a standard care (N = 20) condition. The intervention included provision of information, coping skills training, and parent coaching. Parents participating in the intervention had a significant reduction in anxiety following the intervention relative to parents in standard care. Trained parents displayed fewer distress-promoting and more coping-promoting behaviors during the procedure, even though parents in both conditions reported similar levels of anxiety during the procedure. Involving parents in children's interventions is crucial to reduce parent distress and prepare parents to assist their child during the medical procedure.     

Temperament moderates the effect of the verbal threat information pathway on children's heart rate responses to novel animals

Temperamental variables such as trait anxiety are risk factors in children for the development of anxiety disorders. This experiment aimed to test whether temperament moderates the effect of verbal threat information on the physiological component of the fear emotion. An experiment is reported in which 6-10 year old children's (N = 54) fear beliefs about novel animals were measured. They were then given threat, positive or no verbal information about these animals following which their heart rate was recorded while they placed their hands in boxes that they believed these animals inhabited. Children also completed a questionnaire measure of trait anxiety. Child-reported temperament moderated the effect that threat information has on the physiological component of the fear emotion. Fear information is, therefore, a possible mechanism through which temperament leads children to acquire animal fears.