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Maladaptive Daydreaming Underlies Inattention for a Subgroup of Adults With ADHD
A better diagnosis for some individuals categorized as having attention-deficit/hyperactivity disorder (ADHD) may be maladaptive daydreaming, suggests a study published in the Journal of Clinical Psychology.
“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,” said corresponding author Nirit Soffer-Dudek, MD, of Ben-Gurion University of the Negev in Israel. “Formally classifying maladaptive daydreaming as a mental disorder would enable psychological practitioners to better assist many of their patients.”
Maladaptive daydreaming involves excessive immersion and engagement in realistic daydreams that can last hours and impair normal social, occupational, and academic functioning. Previous research has found high rates of ADHD among people with maladaptive daydreaming. To further probe the cooccurrence, this study investigated the rate of maladaptive daydreaming among 83 adults diagnosed with ADHD.
“This exploration was based on the notion that a majority of adults with maladaptive daydreaming will meet the criteria for ADHD but that their attention deficit is secondary to their core problem of becoming addicted to their immersive, fanciful daydreaming,” the authors wrote.
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Just 1 in 5 participants with ADHD, or 20.5% of the study population, met criteria for maladaptive daydreaming, researchers reported. Those meeting maladaptive daydreaming criteria had significantly increased depression and loneliness, and lower self-esteem, compared with participants with ADHD only.
“Our findings suggest that there is a subgroup of those diagnosed with ADHD who would benefit more from a diagnosis of maladaptive daydreaming,” said Dr Soffer-Dudek.
If further research supports the distinction, the Diagnostic and Statistical Manual of Mental Disorders (DSM) should recognize maladaptive daydreaming in an upcoming edition, the authors advised.
“Although this should be explored in future studies, we believe that the inattention mechanism in maladaptive daydreaming may be essentially different from that experienced by people with ‘pure’ or typical ADHD,” they wrote. “Thus, we posit that if maladaptive daydreaming were included in the DSM, the diagnosis of ADHD might have been superfluous in certain cases. This is because maladaptive daydreaming would better explain the clinical picture including the resulting inattention.”
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