Intense Imagery Movements May Lead to Maladaptive Daydreaming: A Case Series and Literature Review

Tammy Hedderly, Claire Eccles, Osman Malik, Farah Abdulsatar, Clare Mitchell, Tamsin Owen, Nirit Soffer-Dudek, Claire Grose, Thomas V. Fernandez, Sally Robinson, Eli Somer

Research output: Contribution to journalReview articlepeer-review


Background: This case series highlights the connection between childhood intense imagery movements (IIM) and adult-reported maladaptive daydreaming (MD). Motor stereotypies occur in typically developing children and also with co-occurring neurodevelopmental differences. A subgroup with complex motor stereotypies reports accompanying intense imagery, often enhanced by the movements. This phenomenon can persist into adulthood and, in some cases, will need active management to prevent significant distress and impairment. Cases: Six adults, self-reporting maladaptive daydreaming associated with stereotypies, are presented to demonstrate the associations. Literature Review: The clinical significance and function of IIM and MD are unclear, but several hypotheses are discussed, including the mechanism of emotional regulation through sensory seeking, as a process for processing childhood psychological trauma, as intrusive thoughts or images as part of a subtype of Obsessive Compulsive Disorder, or as a result of diverse attentional networks seen in neurodevelopmental disorders. Conclusions: This paper highlights important connections between IIM and MD. Many adults with MD show a childhood origin of stereotypical movements. Whilst immersive daydreaming may provide creativity and emotional regulation, there is evidence of distress and impairment of function for some adults, leading to MD diagnoses. Recognizing this phenomenon is important for all neurologists and physicians working with stereotypical movements.

Original languageEnglish
Pages (from-to)716-719
Number of pages4
JournalMovement Disorders Clinical Practice
Issue number6
Early online date27 Mar 2024
StatePublished - Jun 2024

Bibliographical note

Publisher Copyright:
© 2024 The Authors. Movement Disorders Clinical Practice published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.


  • default mode network
  • hyperphantasia
  • intense imagery movements
  • maladaptive daydreaming
  • stereotyped behavior

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology


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