The Comorbidity of Daydreaming Disorder (Maladaptive Daydreaming)

Abstract

To determine the comorbidity profile of individuals meeting criteria for a proposed new disorder, daydreaming disorder (more commonly known as maladaptive daydreaming [MD]), the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) and the Structured Clinical Interview for DSM-IV Dissociative Disorders were administered to 39 participants who met criteria for MD on a structured interview. We determined high rates of comorbidity: 74.4% met criteria for more than three additional disorders, and 41.1% met criteria for more than four. The most frequent comorbid disorder was attention deficit hyperactivity disorder (76.9%); 71.8% met criteria for an anxiety disorder, 66.7% for a depressive disorder, and 53.9% for an obsessive-compulsive or related disorder. Notably, 28.2% have attempted suicide. Individuals meeting criteria for MD have complex psychiatric problems spanning a range of DSM-5 disorders. This finding provides evidence that MD is different than normal daydreaming and that these individuals experience considerable distress and impairment.

Trapped in a Daydream: Daily Elevations in Maladaptive Daydreaming Are Associated With Daily Psychopathological Symptoms

“…Examining the characteristics of the sample, our data suggested that this was more of a clinical than a non-clinical sample; 87% were above the clinical cutoff for suspected MD, over two thirds of the sample had been in therapy at least once in their lives, and over half of the sample reported having received at least one psychiatric diagnosis. This finding is in accordance with previous research suggesting that MD is characterized by high levels of concomitant psychopathology ( 30 ). On average, as a group, on their first assessment participants reported spending 4.5 h actively engaging in daydreaming on that single day, suggesting that their MD was indeed time-consuming and excessive, taking up over a quarter of their waking time.…”

“…Notably, despite the finding that obsessive-compulsive symptoms are a central mechanism in the daily dynamics of MD, only a small subset of our sample reported having a diagnosis of OCD (5 participants, which amounts to only 6.49% of the sample). This discrepancy suggests that obsessive-compulsive symptoms and MD share common mechanisms and interact with each other on one hand, but MD does not seem to be merely a subtype of OCD on the other hand [also see ( 30 )]. Many individuals with MD report that they are constantly drawn to daydreaming in a compulsory fashion, and have difficulty controlling their thoughts ( 26 , 35 ).…”

“…Although we did not specify a criterion for the severity or maladaptation of MD required for inclusion in the study, but rather permitted individual differences in MD severity, most of our final sample (67 of the 77, which are 87%) was above the clinical cutoff score recently identified for clinical-level MD, that is 50 or above on the MDS ( 1 ). Similarly, in a study sampled in the same way ( 30 ), over 85% of the sample met this criterion; a structured clinical interview on that subset of participants demonstrated that they were highly psychopathological, with multiple co-morbid diagnoses. Almost half were unemployed and over a quarter of the sample had attempted suicide at least once.…”

“…Despite evidence that MD was associated with considerable suffering and dysfunctionality [( 28 ), a comparison of individuals who were self-classified based on provided criteria as either maladaptive ( n = 340) or non-maladaptive ( n = 107) daydreamers], therapists were reported to often be dismissive of the condition, offer no help, or provide unsuccessful treatment for better known diagnoses [( 26 , 27 ), and see also ( 29 ), a clinical case study of a person diagnosed with both a validated MD scale and a reliable MD diagnostic interview]. A recent study on clinical-level maladaptive daydreamers, showed with a structured clinical interview that the sample was highly psychopathological; most had at least four additional diagnoses [( 30 ), diagnostic results of structured clinical interviews with (31) individuals who met criteria for MD].…”

Mind‐wandering in children with and without ADHD

“…Importantly, an ongoing debate discusses that MW may be a heterogeneous construct and that different definitions of MW should be seen as complementary rather than competing (Seli et al , ). For instance, daydreaming is often considered as a part of MW and is in its extreme form referred to as maladaptive daydreaming, which overlaps to a high degree with ADHD (Somer, Soffer‐Dudek, & Ross, ). As such, future studies should address this overlap and differentiation between MW, ADHD and maladaptive daydreaming.…”