4.6 Article

Maladaptive Daydreaming and Obsessive-Compulsive Symptoms: A confirmatory and exploratory investigation of shared mechanisms

Journal

JOURNAL OF PSYCHIATRIC RESEARCH
Volume 136, Issue -, Pages 343-350

Publisher

PERGAMON-ELSEVIER SCIENCE LTD
DOI: 10.1016/j.jpsychires.2021.02.017

Keywords

Maladaptive daydreaming; Obsessive-compulsive disorder; Dissociation; Sense of control; Embodiment; Absorption

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Maladaptive Daydreaming (MD) is a newly proposed mental disorder characterized by excessive, vivid fantasy activity impairing functioning, with a high comorbidity with Obsessive-Compulsive Spectrum Symptoms (OCSS). Dissociation and sense of control significantly mediate the MD-OCSS association, and MD is more strongly related to obsessions than compulsions. Commonly endorsed obsessions and compulsions among MD participants include checking and repetition compulsions, intrusive obsessions, and body-related obsessions and compulsions.
Maladaptive Daydreaming (MD) is a newly proposed mental disorder characterized by excessive, vivid fantasy activity impairing functioning. There is a high comorbidity of MD with Obsessive-Compulsive Spectrum Symptoms (OCSS), yet the mechanisms responsible for this relationship are still unclear. The present study set out to explore the relationship between MD and OCSS by: (1) examining dissociation, trauma, sense of control, and mind-wandering as potential mediators; (2) exploring whether MD is more strongly related to obsessions or compulsions; and (3) identifying patterns of specific obsessions and/or compulsions common in an MD sample. A group of 510 participants with self-identified MD completed a battery of online questionnaires. Dissociation and sense of control significantly mediated the MD-OCSS association. MD was moderately related to both obsessions and compulsions but was significantly more strongly related to the former. Frequently endorsed obsessions and compulsions among MD participants included checking and repetition compulsions, intrusive obsessions, and body-related obsessions and compulsions. We conclude that dissociative mechanisms, including dissociative absorption, play a major role in the relationship between MD and OCSS and may lead to consequent checking when transitioning back to reality, altered embodiment, intrusive images, and thoughts, and an impaired sense of mental control. Clinicians working with OCSS should be aware of the possible role of MD in the development or maintenance of symptoms. Future work should develop useful interventions for this type of shared psychopathology.

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