Original Article

Child Psychiatry & Human Development

, Volume 44, Issue 1, pp 186-199

First online:

Nighttime Fears and Fantasy–Reality Differentiation in Preschool Children

  • Tamar ZisenwineAffiliated withSchool of Psychological Science, Tel Aviv University
  • , Michal KaplanAffiliated withSchool of Psychological Science, Tel Aviv University
  • , Jonathan KushnirAffiliated withSleep and Anxiety Center for Kids, Houston University
  • , Avi SadehAffiliated withSchool of Psychological Science, Tel Aviv University Email author 

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Nighttime fears are very common in preschool years. During these years, children’s fantasy–reality differentiation undergoes significant development. Our study was aimed at exploring the links between nighttime fears and fantasy–reality differentiation in preschool children. Eighty children (aged: 4–6 years) suffering from severe nighttime fears were compared with 32 non-fearful controls. Fears were assessed using child and parental reports. Children viewed images depicting fantastic or real entities and situations, and were asked to report whether these were imaginary or could occur in real life. The results revealed that children with nighttime fears demonstrated more fantasy–reality confusion compared to their controls. These differences in fantasy–reality differentiation were more pronounced in younger children. Additional significant associations were found between fantasy–reality differentiation and age and specific characteristics of the stimuli. These preliminary findings, suggesting a developmental delay in fantasy–reality differentiation in children with nighttime fears, have significant theoretical and clinical implications.


Nighttime fears Anxiety Preschool Child Fantasy Reality