Summary: Study finds a subgroup of patients diagnosed with ADHD who would benefit more from a diagnosis of maladaptive daydreaming.
Source: Ben-Gurion University of the Negev
Maladaptive daydreaming (MD) may be a better diagnosis for some people than ADHD, according to a new study by Ben-Gurion University of the Negev researchers, in collaboration with the University of Haifa.
MD is a condition whereby people slip into involved highly detailed and realistic daydreams that can last hours at the cost of normal functioning. It has not yet been recognized as a formal psychiatric syndrome.
However, Dr. Nirit Soffer-Dudek of the Consciousness and Psychopathology Laboratory in the Department of Psychology at BGU is one of the foremost experts on the condition and is hoping to get MD added to the next edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM VI), by promoting rigorous research on the subject.
“Some individuals who become addicted to their fanciful daydreams experience great difficulty in concentrating and focusing their attention on academic and vocational tasks, yet they find that an ADHD diagnosis and the subsequent treatment plan does not necessarily help them. Formally classifying MD as a mental disorder would enable psychological practitioners to better assist many of their patients,” says Dr. Soffer-Dudek.
Previous studies had found high levels of ADHD in those also presenting with MD, thereby raising the question of whether MD was separate from ADHD.
In the current study, published recently in the Journal of Clinical Psychology, doctoral candidate Ms. Nitzan Theodor-Katz, together with Dr. Soffer-Dudek and their colleagues from the University of Haifa, assessed 83 adults diagnosed with ADHD for inattention symptoms, MD, depression, loneliness, and self-esteem.
Of those, about 20% met the proposed diagnostic criteria for MD, with significantly higher rates of depression, loneliness, and lowered self-esteem, compared to those with ADHD that did not meet criteria for MD.
“Our findings suggest that there is a subgroup of those diagnosed with ADHD who would benefit more from a diagnosis of MD,” says Dr. Soffer-Dudek.
Additional researchers include Prof. Eli Somer and Dr. Rinatya Maaravi Hesseg of the University of Haifa.
Could immersive daydreaming underlie a deficit in attention? The prevalence and characteristics of maladaptive daydreaming in individuals with attention-deficit/hyperactivity disorder
Maladaptive daydreaming (MD) entails excessive immersion and engagement in complex fantasy worlds, causing distress and impairing functioning. Maladaptive Daydreamers often report that existing diagnostic labels are unhelpful for them. Previous studies reported high rates of comorbid attention deficit hyperactivity disorder (ADHD) among persons with MD, raising the question of their separateness. This study explored whether MD differs essentially from ADHD by examining an ADHD sample, hypothesizing a much lower incidence of MD.
Adults diagnosed with ADHD (N = 83) were assessed for ADHD symptoms, MD, depression, loneliness, and self-esteem. Participants who exceeded the study’s cutoff score for suspected MD were invited to participate in a structured diagnostic interview for MD.
In accordance with the hypothesis, only 20.5% of the ADHD sample met the proposed diagnostic criteria for MD. Compared with ADHD-only participants, this subgroup presented increased depression, loneliness, and lowered self-esteem.
MD has unique clinical characteristics that are distinct from ADHD. We suggest that in some cases presenting with ADHD symptoms, an MD conceptualization may better explain the clinical picture. Future research should aim at a better differentiation of daydreaming, ADHD, and related constructs such as mind-wandering.