DARC-NESS: a mastery-based cognitive-behavioral model for treating chronic nightmares in youth
Lisa DeMarni Cromer, Emily Kaier Cromwell, Lauren Prince, Tara R. Buck
Frontiers in Sleep February 27, 2026 DOI: 10.3389/frsle.2026.1772987 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Theoretical or philosophical paper Peer reviewed |
|---|---|
| Topics | Dreaming |
| Keywords | Psychological intervention Dysfunctional family Distress Intervention counseling Mnemonic Dream Sleep system call Sleep deprivation Cognitive behavioral therapy Psychotherapist Cognition Clinical psychology Sleep disorder Sleep hygiene Cognitive therapy Cognitive model |
| Key points | Proposes that nightmare self-efficacy is a central mechanism in the maintenance of chronic nightmares, integrated into the DARC-NESS model. |
Abstract
Theories of chronic nightmare maintenance highlight dysfunctional beliefs about sleep and nightmares, distress and arousal, anticipatory anxiety, maladaptive sleep habits, and sleep deprivation as perpetuating factors that maintain nightmare disorder over time. Theories of nightmare treatment suggest that self-efficacy is a common factor in nightmare mitigation. The current article introduces DARC-NESS, a multi-component theory of nightmare maintenance that emphasizes nightmare self-efficacy as a central mechanism influencing the maintenance cycle at multiple points. DARC-NESS is a mnemonic for the model's components: Dream (nightmare) content, Appraisals, Resources for regulation, Conditioned arousal, Nightmare Efficacy, Sleep hygiene and patterns, and Sleep quality and quantity, that interact to perpetuate nightmares. This model provides the theoretical basis for cognitive behavioral therapy (CBT) for child nightmares. The manuscript proposes treatment counterparts to each model component and presents a case illustration demonstrating how these interventions can disrupt the vicious cycle of chronic nightmares. Finally, flexible clinical applications are offered to guide clinicians in selecting and sequencing modular intervention elements to match individual case presentations.
Comparable studies
Other theoretical and historical papers on dreaming, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Dreaming: a conceptual framework for philosophy of mind and empirical research | 2016 | Theoretical or philosophical paper | |
| Metaphor and hyperassociativity: the imagination mechanisms behind emotion assimilation in sleep and dreaming | 2015 | Theoretical or philosophical paper | |
| Varieties of Lucid Dreaming Experience | 2000 | Theoretical or philosophical paper | |
| Experimental Research on Dreaming: State of the Art and Neuropsychoanalytic Perspectives | 2011 | Theoretical or philosophical paper | |
| The Neurobiology of Consciousness: Lucid Dreaming Wakes Up | 2009 | Theoretical or philosophical paper |
Citations in the library
Cites 9
- Aetiology and treatment of nightmare disorder: State of the art and future perspectives Journal of Sleep Research January 29, 2019
- Psychosocial treatments for nightmares in adults and children: a systematic review BMC Psychiatry April 21, 2023
- Efficacy of a telehealth cognitive behavioral therapy for improving sleep and nightmares in children aged 6–17 Frontiers in Sleep July 11, 2024
- A systematic review of Nightmare prevalence in children. Sleep Medicine Reviews October 1, 2023
- Nightmares and psychiatric symptoms: A systematic review of longitudinal, experimental, and clinical trial studies. Clinical Psychology Review December 17, 2022
and 4 more in the library