Maladaptive daydreaming: Proposed diagnostic criteria and their assessment with a structured clinical interview

Eli Somer; Nirit Soffer-Dudek; Colin A. Ross; Naomi Halpern

doi:10.1037/cns0000114

Maladaptive daydreaming: Proposed diagnostic criteria and their assessment with a structured clinical interview

Eli Somer, Nirit Soffer-Dudek, Colin A. Ross, Naomi Halpern

School of Social Work

Research output: Contribution to journal › Article › peer-review

Abstract

Daydreaming, a common mental activity, can be excessive and accompanied by distress and impaired functioning in daily life. Although currently not formally identified by diagnostic manuals, daydreaming disorder (maladaptive daydreaming [MD]) is a clinically well-defined phenomenon. However, research is lacking regarding the diagnostic reliability of MD. Our aims were (a) to develop diagnostic criteria and a structured interview for MD, (b) to examine the reliability of this measure for distinguishing individuals with and without MD, and (c) to establish an optimal cutoff score for identifying clinical-level MD using an existing self-report measure. Thirty-one individuals who met screening criteria for MD and 31 matched controls completed the self-report measure and participated in 2 structured clinical interviews. Each participant was interviewed independently by 2 clinicians blind to the participant's group membership. Cohen's kappa values for the agreement rate between each interviewer and the screening criterion, and between the 2 interviewers, ranged from good to excellent (κ = .63-.84). A cutoff score of 50 on the self-report measure yielded nearly perfect sensitivity and specificity and good-to-excellent agreement between the self-report measure and the interview (κ = .68 -.81). Our interviews were conducted over the Internet, rather than in person; results might have been influenced by self-selection; and interviewing wider samples is warranted. We found that MD can be diagnosed reliably using a structured interview developed for that purpose. The new diagnostic interview showed excellent agreement with a self-report measure for the disorder. Additionally, we identified a useful cutoff score for future self-report research.

Original language	English
Pages (from-to)	176-189
Number of pages	14
Journal	Psychology of Consciousness: Theory Research, and Practice
Volume	4
Issue number	2
DOIs	https://doi.org/10.1037/cns0000114
State	Published - 2017

Bibliographical note

Funding Information:
The research was approved by the Human Research Ethics Committee of the Faculty of Welfare and Health Sciences at the University of Haifa, Israel. Following approval, we contacted individuals 18 years or older who had contacted the first author following their Google search for such terms as excessive fantasy, respondents from a prior MD research project who indicated an interest in participating in future MD research efforts, and those of consenting age who answered our call for participants. The call for participants was posted on several online MD communities (e.g., Face-book) and sent out as an email invitation to members of MD listservs (e.g., Yahoo MD Forum). The call described the study and requested interested individuals with MD to recruit a counterpart participant from their location, of the same gender and age who, to the best of their knowledge, did not suffer from MD. We did not rely solely on this lay classification of counterparts. The allocation of participants to the research and the control groups was ultimately based on their responses to an MD screening question (described subsequently). Each group (MD and controls) comprised n = 31, including 20 females and 11 males (62 participants in total). The participants’ ages ranged from 18 to 60 in the MD group and from 18 to 63 in the control group. A paired-samples t test indicated no differences between the groups in age (MD group M = 27.84, SD = 10.80, control group M = 28.68, SD = 10.56), t(30) = 1.57, p > .05. The 31 pairs who participated were from 15 countries around the world: eight from the United States of America, four from Israel, three from Canada, three from Italy, two from Germany, two from Australia, and single pairs from Belgium, Brazil, Croatia, India, Indonesia, Pakistan, Sri Lanka, Swaziland, and the United Kingdom. We offered no monetary or other incentives to participate in this study.

Publisher Copyright:
© 2017 American Psychological Association.

Keywords

Absorption
Assessment
Diagnosis
Fantasy
Maladaptive daydreaming

ASJC Scopus subject areas

Social Psychology
Neuropsychology and Physiological Psychology
Experimental and Cognitive Psychology
Clinical Psychology

Access to Document

10.1037/cns0000114

Cite this

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title = "Maladaptive daydreaming: Proposed diagnostic criteria and their assessment with a structured clinical interview",

abstract = "Daydreaming, a common mental activity, can be excessive and accompanied by distress and impaired functioning in daily life. Although currently not formally identified by diagnostic manuals, daydreaming disorder (maladaptive daydreaming [MD]) is a clinically well-defined phenomenon. However, research is lacking regarding the diagnostic reliability of MD. Our aims were (a) to develop diagnostic criteria and a structured interview for MD, (b) to examine the reliability of this measure for distinguishing individuals with and without MD, and (c) to establish an optimal cutoff score for identifying clinical-level MD using an existing self-report measure. Thirty-one individuals who met screening criteria for MD and 31 matched controls completed the self-report measure and participated in 2 structured clinical interviews. Each participant was interviewed independently by 2 clinicians blind to the participant's group membership. Cohen's kappa values for the agreement rate between each interviewer and the screening criterion, and between the 2 interviewers, ranged from good to excellent (κ = .63-.84). A cutoff score of 50 on the self-report measure yielded nearly perfect sensitivity and specificity and good-to-excellent agreement between the self-report measure and the interview (κ = .68 -.81). Our interviews were conducted over the Internet, rather than in person; results might have been influenced by self-selection; and interviewing wider samples is warranted. We found that MD can be diagnosed reliably using a structured interview developed for that purpose. The new diagnostic interview showed excellent agreement with a self-report measure for the disorder. Additionally, we identified a useful cutoff score for future self-report research.",

keywords = "Absorption, Assessment, Diagnosis, Fantasy, Maladaptive daydreaming",

author = "Eli Somer and Nirit Soffer-Dudek and Ross, {Colin A.} and Naomi Halpern",

note = "Funding Information: The research was approved by the Human Research Ethics Committee of the Faculty of Welfare and Health Sciences at the University of Haifa, Israel. Following approval, we contacted individuals 18 years or older who had contacted the first author following their Google search for such terms as excessive fantasy, respondents from a prior MD research project who indicated an interest in participating in future MD research efforts, and those of consenting age who answered our call for participants. The call for participants was posted on several online MD communities (e.g., Face-book) and sent out as an email invitation to members of MD listservs (e.g., Yahoo MD Forum). The call described the study and requested interested individuals with MD to recruit a counterpart participant from their location, of the same gender and age who, to the best of their knowledge, did not suffer from MD. We did not rely solely on this lay classification of counterparts. The allocation of participants to the research and the control groups was ultimately based on their responses to an MD screening question (described subsequently). Each group (MD and controls) comprised n = 31, including 20 females and 11 males (62 participants in total). The participants{\textquoteright} ages ranged from 18 to 60 in the MD group and from 18 to 63 in the control group. A paired-samples t test indicated no differences between the groups in age (MD group M = 27.84, SD = 10.80, control group M = 28.68, SD = 10.56), t(30) = 1.57, p > .05. The 31 pairs who participated were from 15 countries around the world: eight from the United States of America, four from Israel, three from Canada, three from Italy, two from Germany, two from Australia, and single pairs from Belgium, Brazil, Croatia, India, Indonesia, Pakistan, Sri Lanka, Swaziland, and the United Kingdom. We offered no monetary or other incentives to participate in this study. Publisher Copyright: {\textcopyright} 2017 American Psychological Association.",

year = "2017",

doi = "10.1037/cns0000114",

language = "English",

volume = "4",

pages = "176--189",

journal = "Psychology of Consciousness: Theory Research, and Practice",

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AU - Ross, Colin A.

AU - Halpern, Naomi

N1 - Funding Information: The research was approved by the Human Research Ethics Committee of the Faculty of Welfare and Health Sciences at the University of Haifa, Israel. Following approval, we contacted individuals 18 years or older who had contacted the first author following their Google search for such terms as excessive fantasy, respondents from a prior MD research project who indicated an interest in participating in future MD research efforts, and those of consenting age who answered our call for participants. The call for participants was posted on several online MD communities (e.g., Face-book) and sent out as an email invitation to members of MD listservs (e.g., Yahoo MD Forum). The call described the study and requested interested individuals with MD to recruit a counterpart participant from their location, of the same gender and age who, to the best of their knowledge, did not suffer from MD. We did not rely solely on this lay classification of counterparts. The allocation of participants to the research and the control groups was ultimately based on their responses to an MD screening question (described subsequently). Each group (MD and controls) comprised n = 31, including 20 females and 11 males (62 participants in total). The participants’ ages ranged from 18 to 60 in the MD group and from 18 to 63 in the control group. A paired-samples t test indicated no differences between the groups in age (MD group M = 27.84, SD = 10.80, control group M = 28.68, SD = 10.56), t(30) = 1.57, p > .05. The 31 pairs who participated were from 15 countries around the world: eight from the United States of America, four from Israel, three from Canada, three from Italy, two from Germany, two from Australia, and single pairs from Belgium, Brazil, Croatia, India, Indonesia, Pakistan, Sri Lanka, Swaziland, and the United Kingdom. We offered no monetary or other incentives to participate in this study. Publisher Copyright: © 2017 American Psychological Association.

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N2 - Daydreaming, a common mental activity, can be excessive and accompanied by distress and impaired functioning in daily life. Although currently not formally identified by diagnostic manuals, daydreaming disorder (maladaptive daydreaming [MD]) is a clinically well-defined phenomenon. However, research is lacking regarding the diagnostic reliability of MD. Our aims were (a) to develop diagnostic criteria and a structured interview for MD, (b) to examine the reliability of this measure for distinguishing individuals with and without MD, and (c) to establish an optimal cutoff score for identifying clinical-level MD using an existing self-report measure. Thirty-one individuals who met screening criteria for MD and 31 matched controls completed the self-report measure and participated in 2 structured clinical interviews. Each participant was interviewed independently by 2 clinicians blind to the participant's group membership. Cohen's kappa values for the agreement rate between each interviewer and the screening criterion, and between the 2 interviewers, ranged from good to excellent (κ = .63-.84). A cutoff score of 50 on the self-report measure yielded nearly perfect sensitivity and specificity and good-to-excellent agreement between the self-report measure and the interview (κ = .68 -.81). Our interviews were conducted over the Internet, rather than in person; results might have been influenced by self-selection; and interviewing wider samples is warranted. We found that MD can be diagnosed reliably using a structured interview developed for that purpose. The new diagnostic interview showed excellent agreement with a self-report measure for the disorder. Additionally, we identified a useful cutoff score for future self-report research.

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Maladaptive daydreaming: Proposed diagnostic criteria and their assessment with a structured clinical interview

Abstract

Bibliographical note

Keywords

ASJC Scopus subject areas

Access to Document

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