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Soffer-Dudek N, Oh H. Maladaptive daydreaming: A shortened assessment measure and its mental health correlates in a large United States sample. Compr Psychiatry 2024; 129:152441. [PMID: 38061294 DOI: 10.1016/j.comppsych.2023.152441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 11/26/2023] [Accepted: 12/01/2023] [Indexed: 01/10/2024] Open
Abstract
BACKGROUND AND AIMS Maladaptive Daydreaming (MD) is a suggested syndrome where individuals addictively engage in fanciful, narrative and emotional daydreaming for hours on end, often relying on stereotypical movements and music to facilitate the absorbed state. Many individuals suffering from MD to the point of clinically significant distress and functional impairment have advocated for its medicalization as a disorder. Maladaptive daydreamers exhibit high rates of psychopathology, but most studies were biased by self-selection. We developed a brief measure for efficient assessment of suspected MD and then administered it in a large non-selected US sample to gauge the significance of MD for public mental health. METHODS Two previous datasets were utilized to develop the 5-item measure, labeled the Maladaptive Daydreaming Short Form (MD-SF5). Then, a large survey was conducted using the Qualtrics panel, administering the MD-SF5 alongside several validated measures of mental health to a general sample of panelists (N = 2512, 84.6% females, age M = 39.74, SD = 18.53, Race/Ethnicity: 66.3% White, 14.7% Black, 9.3% Hispanic, and 9.7% Other). RESULTS The MD-SF5 showed good to excellent agreement with the existing measure. Generally, the new sample had high psychopathology rates. Suspected MD was associated with psychological distress, loneliness, psychotic experiences, heavy drinking, and suicidality. Notably, even after controlling for psychological distress, suspected maladaptive daydreamers were more than twice as likely to have recently attempted suicide (Odds Ratio = 2.44, 95% CI [1.44, 4.16], Wald = 10.86, p = .001). DISCUSSION AND CONCLUSIONS MD harbors public health significance and can be screened for with a short self-report tool. Thus, MD should be addressed by mental health practitioners.
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Affiliation(s)
- Nirit Soffer-Dudek
- Department of Psychology, Ben-Gurion University of the Negev, P.O.B. 653, Beer-Sheva 8410501, Israel.
| | - Hans Oh
- Suzanne Dworak Peck School of Social Work, University of Southern California, Los Angeles, CA, USA.
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Cardeña E, Lindström L, Goldin P, van Westen D, Mårtensson J. A neurophenomenological fMRI study of a spontaneous automatic writer and a hypnotic cohort. Brain Cogn 2023; 170:106060. [PMID: 37421816 DOI: 10.1016/j.bandc.2023.106060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 06/28/2023] [Accepted: 06/28/2023] [Indexed: 07/10/2023]
Abstract
PURPOSE To evaluate the neurophenomenology of automatic writing (AW) in a spontaneous automatic writer (NN) and four high hypnotizables (HH). METHODS During fMRI, NN and the HH were cued to perform spontaneous (NN) or induced (HH) AW, and a comparison task of copying complex symbols, and to rate their experience of control and agency. RESULTS Compared to copying, for all participants AW was associated with less sense of control and agency and decreased BOLD signal responses in brain regions implicated in the sense of agency (left premotor cortex and insula, right premotor cortex, and supplemental motor area), and increased BOLD signal responses in the left and right temporoparietal junctions and the occipital lobes. During AW, the HH differed from NN in widespread BOLD decreases across the brain and increases in frontal and parietal regions. CONCLUSIONS Spontaneous and induced AW had similar effects on agency, but only partly overlapping effects on cortical activity.
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Affiliation(s)
- Etzel Cardeña
- CERCAP, Department of Psychology, Lund University, Sweden.
| | - Lena Lindström
- CERCAP, Department of Psychology, Lund University, Sweden
| | | | - Danielle van Westen
- Institution for Clinical Sciences, Diagnostic Radiology, Lund University, Sweden
| | - Johan Mårtensson
- Department of Clinical Sciences Lund, Logopedics, Phoniatrics and Audiology, Lund University, Sweden
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Soffer-Dudek N. Obsessive-compulsive symptoms and dissociative experiences: Suggested underlying mechanisms and implications for science and practice. Front Psychol 2023; 14:1132800. [PMID: 37051604 PMCID: PMC10084853 DOI: 10.3389/fpsyg.2023.1132800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 03/03/2023] [Indexed: 03/29/2023] Open
Abstract
A strong and specific link between obsessive-compulsive disorder or symptoms (OCD/S) and a tendency for dissociative experiences (e.g., depersonalization-derealization, absorption and imaginative involvement) cannot be explained by trauma and is poorly understood. The present theoretical formulation proposes five different models conceptualizing the relationship. According to Model 1, dissociative experiences result from OCD/S through inward-focused attention and repetition. According to Model 2, dissociative absorption causally brings about both OCD/S and associated cognitive risk factors, such as thought-action fusion, partly through impoverished sense of agency. The remaining models highlight common underlying causal mechanisms: temporo-parietal abnormalities impairing embodiment and sensory integration (Model 3); sleep alterations causing sleepiness and dreamlike thought or mixed sleep-wake states (Model 4); and a hyperactive, intrusive imagery system with a tendency for pictorial thinking (Model 5). The latter model relates to Maladaptive Daydreaming, a suggested dissociative syndrome with strong ties to the obsessive-compulsive spectrum. These five models point to potential directions for future research, as these theoretical accounts may aid the two fields in interacting with each other, to the benefit of both. Finally, several dissociation-informed paths for further developing clinical intervention in OCD are identified.
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Affiliation(s)
- Nirit Soffer-Dudek
- The Consciousness and Psychopathology Laboratory, Department of Psychology, Ben-Gurion University of the Negev, Be’er Sheva, Israel
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Evaluating Virtual Hand Illusion through Realistic Appearance and Tactile Feedback. MULTIMODAL TECHNOLOGIES AND INTERACTION 2022. [DOI: 10.3390/mti6090076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
We conducted a virtual reality study to explore virtual hand illusion through three levels of appearance (Appearance dimension: realistic vs. pixelated vs. toon hand appearances) and two levels of tactile feedback (Tactile dimension: no tactile vs. tactile feedback). We instructed our participants to complete a virtual assembly task in this study. Immediately afterward, we asked them to provide self-reported ratings on a survey that captured presence and five embodiment dimensions (hand ownership, touch sensation, agency and motor control, external appearance, and response to external stimuli). The results of our study indicate that (1) tactile feedback generated a stronger sense of presence, touch sensation, and response to external stimuli; (2) the pixelated hand appearance provided the least hand ownership and external appearance; and (3) in the presence of the pixelated hand, prior virtual reality experience of participants impacted their agency and motor control and their response to external stimuli ratings. This paper discusses our findings and provides design considerations for virtual reality applications with respect to the realistic appearance of virtual hands and tactile feedback.
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Wieder L, Brown RJ, Thompson T, Terhune DB. Hypnotic suggestibility in dissociative and related disorders: A meta-analysis. Neurosci Biobehav Rev 2022; 139:104751. [PMID: 35760389 DOI: 10.1016/j.neubiorev.2022.104751] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 06/04/2022] [Accepted: 06/22/2022] [Indexed: 12/15/2022]
Abstract
Elevated responsiveness to verbal suggestions is hypothesized to represent a predisposing factor for dissociative disorders (DDs) and related conditions. However, the magnitude of this effect has not been estimated in these populations nor has the potential moderating influence of methodological limitations on effect size variability across studies. This study assessed whether patients with DDs, trauma- and stressor-related disorders (TSDs), and functional neurological disorder (FND) display elevated hypnotic suggestibility. A systematic literature search identified 20 datasets. A random-effects meta-analysis revealed that patients displayed greater hypnotic suggestibility than controls, Hedges's g=0.92 [0.66, 1.18]. This effect was observed in all subgroups but was most pronounced in the DDs. Although there was some evidence for publication bias, a bias-corrected estimate of the group effect remained significant, g=0.57 [0.30, 0.85]. Moderation analyses did not yield evidence for a link between effect sizes and methodological limitations. These results demonstrate that DDs and related conditions are characterized by elevated hypnotic suggestibility and have implications for the mechanisms, risk factors, and treatment of dissociative psychopathology.
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Affiliation(s)
- Lillian Wieder
- Department of Psychology, Goldsmiths, University of London, London, UK
| | - Richard J Brown
- School of Health Sciences, University of Manchester, Manchester, UK; Psychotherapy Services, Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Sciences Centre, UK
| | - Trevor Thompson
- Centre for Chronic Illness and Ageing, University of Greenwich, London, UK
| | - Devin B Terhune
- Department of Psychology, Goldsmiths, University of London, London, UK; Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
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Davies J. Explaining the illusion of independent agency in imagined persons with a theory of practice. PHILOSOPHICAL PSYCHOLOGY 2022. [DOI: 10.1080/09515089.2022.2043265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Jim Davies
- Department of Cognitive Science, Carleton University, Ottawa, Canada
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Martins HADL, Ribas VR, Dos Santos Ribas KH, da Fonseca Lins L, Mainieri AG. Case Report: Anomalous Experience in a Dissociative Identity and Borderline Personality Disorder. Front Psychiatry 2022; 13:662290. [PMID: 35923455 PMCID: PMC9339793 DOI: 10.3389/fpsyt.2022.662290] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 06/03/2022] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION Dissociative identity disorder, formerly called multiple personality disorder, is a rupture of identity characterized by the presence of two or more distinct personality states, described in some cultures as an experience of possession. OBJECTIVE The case of a 30-year-old woman with dissociative identity disorder and borderline personality disorder associated with a previous history of anomalous experience was reported. CASE REPORT A 30-year-old woman who fulfilled the DSM-5 criteria for dissociative identity disorder and borderline personality disorder reported the presence of unusual sensory experiences (clairvoyance, premonitory dreams, clairaudience) since she was 5 years old. The patient told that for 12 months she presented episodes in which a "second self" took charge of her actions: she would then speak with a male voice, become aggressive, and require several people to contain her desire for destruction. After 3 months of religious follow-up, and accepting her unusual experiences and trance possessions as normal and natural, she had significant improvement. CONCLUSION When approaching DID and BPD patients, it is necessary to observe the anomalous phenomena (in the light of) closer to their cultural and religious contexts, to promote better results in the treatment of their disorders, which has not been explored in the treatment guide.
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Somer E, Cardeña E, Catelan RF, Soffer-Dudek N. Reality shifting: psychological features of an emergent online daydreaming culture. CURRENT PSYCHOLOGY 2021; 42:1-13. [PMID: 34744401 PMCID: PMC8556810 DOI: 10.1007/s12144-021-02439-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/25/2021] [Indexed: 11/30/2022]
Abstract
Reality shifting (RS) is a trendy mental activity that emerged abruptly following the flare-up of the COVID-19 pandemic in 2020 and seems to be practiced mainly by members of the post-millennial generation. RS, described as the experience of being able to transcend one's physical confines and visit alternate, mostly fictional, universes, is discussed by many on Internet platforms. One RS forum boasts over 40,000 members and RS clips on some social media platforms have been viewed over 1.7 billion times. The experience of shifting is reportedly facilitated by specific induction methods involving relaxation, concentration of attention, and autosuggestion. Some practitioners report a strong sense of presence in their desired realities, reified by some who believe in the concrete reality of the alternate world they shift to. One of the most popular alternate universes involves environments adopted from the Harry Potter book and film series. We describe the phenomenology of RS as reported online and then compare it to related phenomena such as hypnosis, tulpamancy, dissociation, immersive and maladaptive daydreaming, and lucid dreaming. We propose a theoretical model of interactive factors giving rise to RS, and conclude that it is an important, uninvestigated emerging phenomenon and propose future research directions.
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Affiliation(s)
| | - Etzel Cardeña
- Present Address: CERCAP, Department of Psychology, Lund University, Lund, Sweden
| | - Ramiro Figueiredo Catelan
- Present Address: Center for Maladaptive Daydreaming and Emotion Dysregulation Research, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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Millman LSM, Hunter ECM, Orgs G, David AS, Terhune DB. Symptom variability in depersonalization-derealization disorder: A latent profile analysis. J Clin Psychol 2021; 78:637-655. [PMID: 34487354 DOI: 10.1002/jclp.23241] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 06/09/2021] [Accepted: 08/15/2021] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Depersonalization-derealization disorder (DDD) is characterized by diverse symptomatology overlapping with anxiety and dissociative disorders, but the sources of this variability are poorly understood. This study aims to determine whether symptom heterogeneity is attributable to the presence of latent subgroups. METHOD We applied latent profile analysis to psychometric measures of anxiety, depersonalization-derealization, and dissociation in 303 DDD patients. RESULTS The analysis yielded evidence for five discrete subgroups: three of varying severity levels and two moderate-to-severe classes characterized by differential dissociative symptoms. The five classes reliably differed on several nondissociative symptoms, comorbidities, and factors precipitating their diagnosis but did not significantly differ in other symptoms including anxiety. CONCLUSION These results suggest the presence of three distinct DDD subtypes in the upper severity range that are distinguished by differential expression of detachment and compartmentalization symptoms. Further elucidation of these subtypes has potential implications for the etiology, mechanisms, and treatment of DDD.
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Affiliation(s)
| | | | - Guido Orgs
- Department of Psychology, Goldsmiths, University of London, London, UK
| | - Anthony S David
- Institute of Mental Health, University College London, London, UK
| | - Devin B Terhune
- Department of Psychology, Goldsmiths, University of London, London, UK
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Hallucinations and the meaning and structure of absorption. Proc Natl Acad Sci U S A 2021; 118:2108467118. [PMID: 34341112 DOI: 10.1073/pnas.2108467118] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
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