* The power of belief: The children's belief in the doll's power directly affects their actions and the unfolding of the story. Their unwavering dedication to the game, initially a fun distraction, becomes a dangerous obsession that blurs the lines between reality and fiction.
* Facing fear and growing up: The narrative arc tracks the children's journey from childhood innocence to confronting adult anxieties and fears. The escalating horror forces them to mature and grapple with mortality, loss, and the complexities of their relationships.
* The dangers of obsession: The children's intense focus on the doll bones game leads to neglecting their real lives and responsibilities, illustrating the potential pitfalls of becoming fixated on fantasy worlds at the expense of reality.
* The nature of reality and illusion: The book constantly questions what is real and what is imagined, leaving the reader to consider the ambiguous nature of the supernatural events. Are the events supernatural, or are they a manifestation of the children's fears and subconscious desires?
While the book incorporates elements of horror and fantasy, these themes underpin the narrative and offer a deeper exploration of childhood, adolescence, and the human experience.