Maladaptive daydreaming

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Maladaptive daydreaming or excessive daydreaming is a psychological concept first introduced by Eli Somer[1] to describe an extensive fantasy activity that replaces human interaction and/or interferes with academic, interpersonal, or vocational functioning.

Signs and symptoms[edit]

While there are many specific symptoms of a maladaptive daydreamer, someone with this disorder will not necessarily have all of them.[2]

Often maladaptive daydreams are prompted by 'triggers' (stimuli which produce an emotional response) which may include conversational topics, sensory stimuli, or physical experiences. Maladaptive daydreamers may also experience trouble completing routine tasks or going to sleep, due to their desire to continue daydreaming. Oftentimes while maladaptive daydreamers are daydreaming, they will whisper, talk, make facial expressions, or do some sort of repetitive movements, such as pacing.[2]

Maladaptive daydreamers can spend hours simply daydreaming. They may have elaborate fantasies within their minds, often comparable to a complete novel or movie. Many have more than one fantasy in their mind, each with its own characters, setting, plots, etc. Maladaptive daydreamers may become emotionally attached to their characters as well, though they know the characters are not real.[2]

Diagnosis[edit]

The Maladaptive Daydreaming Scale (MDS) is a 14-item self-report instrument designed to gauge abnormal fantasizing. It is a statistically valid and reliable measure of MD that differentiates well between MDers and non-MDers.[3] Mental health diagnoses are only determined based on clinician-administered structured interviews.[4][5] Hence, no official diagnostic tool has been developed to diagnose MD.

Differential diagnosis[edit]

Maladaptive daydreaming is mistakenly and frequently misdiagnosed as schizophrenia[2] which is defined as a mental disorder characterized by abnormal social behavior and failure to recognize what is real.[6] Schizophrenia is considered a psychosis,[7][8][9] whereas maladaptive daydreaming is not considered a psychosis because the Maladaptive Daydreaming Scale (MDS) has been shown to be poorly correlated with a psychosis measure.[3] The fundamental difference between the two is that maladaptive daydreaming patients (MDers) are aware that their daydream characters are not real and they differentiate between what is real and what is not, whereas schizophrenia patients fail to recognize what is real and what is not.[6] MDers do not hear voices or see people that are not real,[2] whereas schizophrenia patients might.[10]

Maladaptive daydreaming is not an official diagnosis, but people who suffer from it tend to agree that it is an intense and prolonged form of daydreaming interfering with their work, relationships, and general activities. People who have this form of daydream have difficulties shifting attention back to their desired task when immersing themselves into a thought. Symptoms reported have indicated a difficulty in attention shifting rather than difficulties in sustaining attention, since they seem to sustain their attention well enough to be immersed in a 3-hour daydream. Attention shifting is the ability to appropriately disengage and shift attention from one object/event to another. More concrete, redirecting one’s focus of attention away from one fixation (i.e. a daydream), towards a different focus of attention (i.e. the task needed to be done). These daydreams are many times reported as involuntary, highly immersive, and repetitive, so maladaptive daydreamers can experience something similar to perseveration seen in people with the Obsessive-compulsive disorder, and the attention shifting difficulties experienced by people with ADHD. Just like people with attention shifting problems do (i.e. ADHD), people who maladaptive daydream tend to constantly and involuntarily shift their attention inward during monotonous performances. The difference is that people who suffer from ADHD don't report having so highly immersive or prolonged daydreams lasting hours at a time, it is assumed due to their general shorter attention span. Maladaptive daydreamers appear to have the ability to maintain and engage attention (sustained attention) and so their inability to focus on an important task rather than their daydream may be due to a difficulty in directing one's attention span, back to the conscious and premeditated task (Attention shifting).

Because of its private nature, it is hard to form a generally agreed upon definition of daydreaming. Probably the single most common connotation is that daydreaming represents a shift of attention away from some primary physical or mental task we have set for ourselves, or away from directly looking at or listening to something in the external environment. Normal daydreaming or conscious fantasy seems most likely to occur under conditions relatively similar to those of night dreaming. A person who is alone in a situation, in which there is very little outside stimulation, perhaps most often just prior to going to sleep, is likely to find themselves engaged in an extensive reverie or interior monologue. Daydreaming has a lot to do with the concept of "mind wandering" and there are more studies done under this concept, than under daydreaming. In studies, most subjects were unaware of their own mind wandering, suggesting that mind wandering is most pronounced when it lacks meta-awareness. The takeaway of these studies was that conflict detection and cognitive control is needed to bring attention back, so people who have a high tendency to mind wander, might most likely have difficulties with this. More research is to be done around the neurobiological aspects that cause a person to daydream this way. We all obsess over things in varying degrees, there is real value in getting stuck on daydreams and being overfocused, but some people suffer from this to such degree that it interferes with their ability to function.

Media coverage[edit]

But most psychologists have never heard of maladaptive daydreaming, and it is not officially recognized as a disorder. Many scoff at the idea that a normal activity like fantasizing could cause such distress. So how can people who believe their daydreaming is out of to control receive help? Is maladaptive daydreaming a syndrome in itself, or is it just one manifestation of another affliction? Where does it come from, and how can it be cured? Most of all, how can the syndrome become better known so excessive fantasizers don’t feel like I did, the only person in the world to spend as much time as possible in my imaginary world?

— Jayne Bigelsen of The Atlantic

Despite it not being an official recognized disorder or pathology, maladaptive daydreaming has received some attention from the media.[11][12][13]

See also[edit]

References[edit]

  1. ^ Somer, Eli. "Maladaptive Daydreaming: A Qualitative Inquiry". Journal of Contemporary Psychotherapy. Journal of Contemporary Psychotherapy. Retrieved 18 May 2014. 
  2. ^ a b c d e "Maladaptive Daydreaming- What Is It?". Medical Daily. 
  3. ^ a b Somer, Eli. "Maladaptive Daydreaming: Development and validation of the Maladaptive Daydreaming Scale (MDS)". Elsevier. Elsevier. Retrieved 26 Feb 2016. 
  4. ^ Steiner, JI. "A comparison of the structured clinical interview for DSM-III-R and clinical diagnoses". J Nerv Ment Dis. 183: 365–9. PMID 7798084. 
  5. ^ Shear, MK (April 2000). "Diagnosis of nonpsychotic patients in community clinics". Am J Psychiatry. 157: 581–7. PMID 10739417. doi:10.1176/appi.ajp.157.4.581. 
  6. ^ a b "Schizophrenia Fact sheet N°397". WHO. September 2015. Retrieved 3 February 2016. 
  7. ^ American Psychiatric Association, 1994 The Diagnostic and Statistical Manual Revision IV (DSM-IV)
  8. ^ Gelder, Michael G; Mayou, Richard; Geddes, John (2005). Psychiatry. New York: Oxford University Press. p. 12. ISBN 978-0-19-852863-0. 
  9. ^ Yuhas, Daisy. "Throughout History, Defining Schizophrenia Has Remained a Challenge (Timeline)". Scientific American Mind (March 2013). Retrieved 2 March 2013. 
  10. ^ Carson VB (2000). Mental health nursing: the nurse-patient journey W.B. Saunders. ISBN 978-0-7216-8053-8. p. 638.
  11. ^ The Atlantic featured an article on Maladaptive Daydreaming. "When Daydreaming Replaces Real Life Should elaborate fantasies be considered a psychiatric disorder?" (April 2015)
  12. ^ CBC Radio's The Current featured an episode on the subject called "Maladaptive daydreaming, a debilitating condition with no escape" (June 2015)
  13. ^ Living in an Imaginary World. Scientific American (January 2014)