Could immersive daydreaming underlie a deficit in attention? The prevalence and characteristics of maladaptive daydreaming in individuals with attention-deficit/hyperactivity disorder

Objective: Maladaptive daydreaming (MD) entails excessive immersion and engagement in complex fantasy worlds, causing distress and impairing functioning. Maladaptive Daydreamers often report that existing diagnostic labels are unhelpful for them. Previous studies reported high rates of comorbid attention deficit hyperactivity disorder (ADHD) among persons with MD, raising the question of their separateness. This study explored whether MD differs essentially from ADHD by examining an ADHD sample, hypothesizing a much lower incidence of MD. Method: Adults diagnosed with ADHD (N = 83) were assessed for ADHD symptoms, MD, depression, loneliness, and self-esteem. Participants who exceeded the study's cutoff score for suspected MD were invited to participate in a structured diagnostic interview for MD. Results: In accordance with the hypothesis, only 20.5% of the ADHD sample met the proposed diagnostic criteria for MD. Compared with ADHD-only participants, this subgroup presented increased depression, loneliness, and lowered self-esteem. Conclusion: MD has unique clinical characteristics that are distinct from ADHD. We suggest that in some cases presenting with ADHD symptoms, an MD conceptualization may better explain the clinical picture. Future research should aim at a better differentiation of daydreaming, ADHD, and related constructs such as mind-wandering.