These patients demonstrated a preference for living in elaborate fantasy worlds and engaging in their inner worlds for more than half of their waking hours, leading to socio-occupational dysfunction.
MD as a construct was first described in six patients who were on treatment for neglect and childhood traumatic events. Maladaptive daydreaming (MD) is described as ‘extensive fantasy activity that replaces human interaction and/or interferes with academic, interpersonal or vocational functioning’, 1 causing clinically significant distress and functional impairment. There is also a need to study treatment and management approaches for treating MD. Further studies are necessary to determine the biopsychosocial factors of MD and its correlates. Patients in clinical setting should be questioned about MD when presenting with excessive use of technology or other forms of behavioural addictions. The therapy focused on behaviour modification and cognitive restructuring.
The patient was managed primarily with psychological intervention. Baseline assessment revealed a Maladaptive Daydreaming Scale-16 score of 65 (cut-off 50) and an Internet Gaming Test-20 score of 86 (cut-off 71). The patient engaged in vivid, fanciful imagery that lasted for hours, leading to social dysfunction and academic deterioration. In this paper, we report the case of a 16-year-old boy who developed internet gaming disorder and MD after experiencing cyberbullying from his peers. MD has also been purported to be a maladaptive strategy to cope with distress, but often leads to uncontrollable absorption in fantasy world, social withdrawal and neglected aspects of everyday life. MD has many features suggestive of behavioural addiction, but research exploring the phenomenology of this clinical construct is limited. Maladaptive daydreaming (MD) is an immersive fantasy activity that leads to distress and socio-occupational dysfunction.
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