Maladaptive Daydreaming among patients with Dissociative Identity Disorder:A prevalence study

Abstract

Maladaptive Daydreaming (MD) is a syndrome involving extensive and compulsive absorption in a vivid fantasized world, with detailed and emotional narratives, replacing interest and investment in real life and resulting in clinical distress and functional impairment. It is often accompanied by stereotypical movements (e.g., pacing, shaking one's hand) or movements embodying the daydream. MD shares some characteristics with dissociation in general and Dissociative Identity Disorder (DID) in particular, such as detachment, discontinuities in experience, and a fragmented sense of self, and they may share etiological mechanisms. Previous research found high rates of MD in a sample with severe dissociative disorders. The present study aimed to assess the prevalence of MD in a cohesive DID sample. N = 67 UK-based patients with current DID, confirmed by an interview with a clinician specializing in dissociative disorders, completed self-report scales assessing dissociation and MD. We assessed most of those with high MD scores using a structured clinical interview for MD. We found that at least a quarter of our DID sample had co-morbid MD, although the actual rate was probably closer to 40 %. Correlations from self-report scales indicated that even within this cohesive sample, a tendency for dissociative “absorption and imaginative involvement” was associated with MD symptoms. DID and MD may share common etiological mechanisms, and MD should be screened for in DID, especially in cases of high absorption.