BGU researcher spearheads broad collaborative effort to include maladaptive daydreaming as a dissociative disorder in psychiatric manuals
Inclusion will spur research and treatment, leading authors argue
Maladaptive daydreaming should be included as a dissociative disorder in psychiatric manuals, Ben-Gurion University of the Negev's Prof. Nirit Soffer-Dudek argues in a position paper just published open access in the prestigious British Journal of Psychiatry . Co-signatories on this position paper include many of the presidents and past presidents of the dissociative disorder societies, indicating widespread agreement in the field. This sends a strong message to the psychiatric community, according to which the field of dissociation is interested in formally accepting MD into it.
Maladaptive daydreaming (MD) is a syndrome whose main symptom is excessive vivid fantasizing to the detriment of normal everyday function.
"Nonspecific treatments often do not improve symptoms," says Prof. Soffer-Dudek of the Department of Psychology, "whereas initial evidence suggests that targeted clinical interventions may be promising for substantially improving well-being."
Prof. Soffer-Dudek is one of the world's leading experts on maladaptive daydreaming.
If MD became a standalone disorder, it would encourage research and treatment and would increase its visibility amongst practitioners, the authors argue.
The authors argued that MD fits criteria similar to many other dissociative disorders already included in diagnostic manuals such as the DSM-5 or the ICD-11. They argued that 1) it is unflexible and structured, 2) it generates and exacerbates psychological distress, 3) other diagnoses do not provide a better explanation of the clinical picture, and as mentioned above, 4) acknowledging it will increase awareness among clinicians and researchers and facilitate the development of specific intervention protocols.
The authors propose clear diagnostic criteria that differentiate MD from occasional or normal daydreaming by including time lengths and indications of "clinically significant distress or impairment," as defined by the DSM.
In addition to immersion and absorption in an elaborate fantasy world that comes at the cost of daily function, the criteria would include stereotypical movement, using daydreaming to cope with distress, feeling annoyed when daydreaming is interrupted, repeated failed attempts to cut back on daydreaming and a preference for daydreaming over real life.
"There has been sufficient research in recent years to support MD's inclusion as a standalone dissociative disorder. Its inclusion in psychiatric manuals would lead to increased awareness which would promote clinical and research-based knowledge about the syndrome and the development of more effective treatment protocols," Prof. Soffer-Dudek concludes.
