Differential diagnosis between maladaptive daydreaming and ADHD: Immersive daydreaming is not simply inattention

Maladaptive daydreaming (MD), a syndrome considered by dissociation researchers to represent a dissociative disorder, entails excessive, addictive immersion into narrative and emotional fantasies, impairing functioning and increasing distress. People with MD often meet the criteria for attention-deficit/hyperactivity disorder (ADHD), as addictive and immersive daydreaming causes inattention. Conversely, most people with ADHD do not suffer from MD, yet commonly score highly on the MD self-report screener, questioning the reliability of MD and ADHD symptom checklists. We examined whether assessing a mental pattern of immersive daydreaming improves the reliability of MD classification. A sample of 156 adults comprising four groups: ADHD (n = 38), MD (n = 49), Both (n = 34), and Controls (n = 35), underwent clinical interviews and completed self-report scales assessing symptoms and immersive daydreaming. As hypothesized, the MD self-report screener was compromised in the face of ADHD. Immersive daydreaming self-reports counteracted that by adding significant unique predictive value for MD identification in the context of ADHD. This indicates that immersive daydreams are distinct mentation not necessarily characterizing ADHD. We suggest a practical cutoff score for identifying high immersive daydreaming which complements MD screening, improving correct MD identification in the context of ADHD.