Sunday, July 21

5 Most Upvoted Questions from Dr. Soffer-Dudek’s AMA

Below are the most popular questions answered by a Maladaptive Daydreaming researcher. r/MaladaptiveDreaming’s annual AMA (ask me anything) was hosted by clinical psychologist Dr. Nirit Soffer Dudek, from Ben-Gurion University of the Negev, this year.  She’s a member of the ICMDR, a leading researcher on the topic of Maladaptive Daydreaming.

Anonymouselo11 asked:
Do you have a favorite part about researching MD or a part of it that you find most fascinating? Also, what are the next steps in the research that you and your colleagues are working on/ is there a specific piece of information that you are hoping to uncover?

Well first of all, thanks so much for your kind words. It is very motivating that a lot of people want us to keep doing this… I have a few most-fascinating parts: (1) links with dissociation/absorption (a theoretical chapter on that which I led just got accepted to a central book on dissociative disorders). In general I’m really interested in dissociative absorption; (2) stereotypical movement, embodiment, self-hypnosis, etc. (3) the idea that some of the people getting an ADHD diagnosis should be getting an MD diagnosis instead; and same for kids with stereotypical movement disorder; and (4) relationships with OCD. There are probably additional ones but those are what come to mind currently…

So currently there are collaborations about epidemiology, and regarding kids with stereotypical movement disorder, and there are students of mine working on sense of agency, on ADHD, and on kids with trauma backgrounds. A chapter on the theoretical and empirical links with dissociation just got accepted and so did a paper on OCD and MD. Those are the central things that come to mind, but not the only ones…

Pumpkin–Queen asked:
Hi Dr. Dudek, since you mentioned it, do you think MD could be a symptom of ADHD or OCD, a disorder of its own, or rather a coping mechanism? 

I definitely think it is a disorder and not a symptom of something else, and that is what the data are showing us as well. OCD and MD are seperate entities but with a lot of co-occurance and probably shared mechanisms. ADHD is a seperate entity but I believe it is probably sometimes diagnosed when a diagnosis of MD would have been better instead.

In one study we found that about 80% of our MD sample met criteria for ADHD (not necessarily with hyperactivity. Many just had the innattention). Our thoughts on this, especially in light of what these people told us, is that the ADHD was actually a result of the MD. In other words, daydreaming addiction interfered with theor ability to concentrate on external tasks. All diagnoses in the DSM have a criterion stating that the symptoms are not better explained by a different syndrome. That means that id MD were in the DSM, the ADHD diagnosis in many cases would be superfluous!

In a new study not yet published, we found that in a sample of people with ADHD, there were much less MDers, not even close to 80%, which is what we hypothesized. This supports the idea that they are seperate entities. There were a small subgroup who we found to have MD within that sample of ADHD.

Regarding OCD, there are definitely shared mechanisms. In a daily study I led, many symptoms of different kinds were elevated on days with more intense MD, but OCD symptoms were the only ones elevated on the days prior to days with more intense MD! (and on the days after, as well). So it seemed like some kind of a cycle, they seem to work together somehow. In a study that just got accepted a few days ago, we found a lot of co-occurance between the two conditions. MDers reported more intrusive thoughts, intrusive noises, intrusive images, and symptoms of checking and/or repeating. It might be because MDers absorbed in their fantasy later feel anxious as to what they have “missed” in rel life, so maybe they feel the need to check what they may have done automatically or repeat their actions.

Regarding coping mechanism – it is also that. See my previous response about how it doesn’t have to be “either-or”.

Vaith_ asked:
Will MD appear in the DSM at one point?

Let’s hope! We are doing our best (-:

Healthy-Appearance-8 asked:
Do you think there could be a link between Maladaptive Daydreaming Disorder and Body Dysmorphia? Seeming as daydreaming is an escapism and coping mechanism for many, many people imagine themselves as a better version of themselves or somebody else entirely.

There is definitely some connection there, yes. A few days ago a new paper got accepted (Salomon-Small, G., Somer, E., Harel-Schwarzmann, M., & Soffer-Dudek, N. (in press). Maladaptive Daydreaming and Obsessive-Compulsive Symptoms: A confirmatory and exploratory investigation of shared mechanisms. Journal of Psychiatric Research) concerning the relationship between MD and OCD-related symptoms. One of our findings was that MDers highly endorsed OCD-spectrum symptoms that relate to the body, including Body dysmorphic symptoms.

Rayduit asked:
Do you think maladaptive daydreaming can be a coping mechanism and not just a disorder of some sort? Do you think it can be helped similar to a way with depression?

Actually, many disorders start out as coping mechanisms, which have in a sense “gone bad” because they are over-used, rigid, or out-of-control, or they solve one problem but create another. Sometimes psychologists look at “what is the symptoms serving?” in order to better understand why a symptom is maintained, and perhaps if that need can be treated then the need for the symptom will decrease. So I don’t think that’s necessarily an “either or” question. So yes, I am sure that many MDers use MD as a coping mechanism, for example, for social problems. Also, we know that some people engage in immersive daydreaming without the distress which turns it into something maladaptive or in other words, a disorder. I definitely think it can be helped by psychotherapy, and we are working on research regarding useful interventions.

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