ABSTRACT
Background: Maladaptive Daydreaming (MD) is a recently identified psychological disorder, characterized by excessively and addictively engaging in vivid, narrative, intensely emotional fantasy activity, at times with the aid of music and/or repetitive movements, causing distress and functional impairment. Over 100,000 self-diagnosed individuals are active online and thousands of them have been researched; yet there are no studies using clinical interviews on large, systematic general (non-MD) samples, to assess the estimated prevalence of this suggested disorder, and establish norms for its main psychometric tool. Methods: Four independent Israeli samples (three student samples, and one sample representing the general Jewish-Israeli population; total N = 1,023) self-reported MD. In two samples, those exceeding the cutoff score for suspected MD were invited for a structured clinical interview. Results: The skewness of most items of the 16-item Maladaptive Daydreaming Scale (MDS-16) supports the notion of MD as a binary construct rather than a normally distributed trait. In the community sample, 4.2% exceeded the cutoff for suspected MD. Rates were higher when focusing on the young adult age group or student samples (5.5-8.5%), suggesting a likely age effect. Following clinical interviews, only 60% of interviewed respondents met criteria for diagnosis, suggesting a true point-prevalence of 2.5% in the Israeli-Jewish population. Conclusions: This is the first systematic clinical evaluation of the prevalence of MD. In an Israeli sample, a point-prevalence of 2.5% was found, like several other internalizing psychiatric syndromes. This result, along with the Non-normal nature of item distribution, both support the validity of MD as a psychological disorder, which should be considered as a potential addition to future psychiatric diagnostic manuals.
ABSTRACT
OBJECTIVE: 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. METHOD: 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. RESULTS: 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. CONCLUSION: 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.
