New Research Explores the Link Between Maladaptive Daydreaming and Late ADHD Diagnosis
Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental condition typically diagnosed in childhood.
However, many individuals remain undiagnosed until adulthood, often struggling with unexplained academic, social, and occupational difficulties.
A recent study published in the Journal of Attention Disorders suggests that maladaptive daydreaming (MD) could be a significant factor delaying ADHD diagnosis until adulthood.
What Is Maladaptive Daydreaming?
Maladaptive daydreaming (MD) is a compulsive mental activity where individuals immerse themselves in vivid, structured fantasies, often interfering with daily life.
This phenomenon, closely linked to ADHD, can serve as an emotional escape and obscure core ADHD symptoms, sometimes to the extent that it interferes with daily life.
Unlike typical mind-wandering, which is common in ADHD, MD involves elaborate, structured narratives that serve as an emotional escape.
These intense daydreams can provide relief from distress but may also contribute to functional impairments by consuming excessive time and distancing individuals from reality.
Key Findings of the Study
Researchers analysed data from 214 adults diagnosed with ADHD at Selçuk University’s Adult Neurodevelopmental Disorders Clinic in Türkiye. They found that only 34.4% of participants had received an ADHD diagnosis in childhood or adolescence, while the remaining 65.6% were diagnosed in adulthood.
A key factor distinguishing the two groups was the presence of maladaptive daydreaming, which was significantly more prevalent among adults diagnosed later in life.
Key Insights from the Study:
Higher MD Scores in Late-Diagnosed ADHD Adults – Individuals diagnosed with ADHD in adulthood exhibited more severe ADHD symptoms and significantly higher MD scores compared to those diagnosed in childhood.
MD as a Predictor of Late ADHD Diagnosis – Statistical analysis indicated that MD severity was associated with an increased likelihood of receiving an ADHD diagnosis later in life, even when controlling for factors like education level, age, and ADHD medication use.
MD Masks ADHD Symptoms – The researchers propose that MD may obscure core ADHD traits, making it more difficult for individuals and professionals to recognize the disorder earlier. This delay in seeking mental health support may contribute to the underdiagnosis of ADHD.
MD Is Linked to Psychiatric Comorbidities – Among adults diagnosed with ADHD later in life, MD was strongly correlated with symptoms of depression, anxiety, and excessive mind-wandering.Researchers analyzed data from 214 adults diagnosed with ADHD at Selçuk University’s Adult Neurodevelopmental Disorders Clinic in Türkiye. They found that only 34.4% of participants had received an ADHD diagnosis in childhood or adolescence, while the remaining 65.6% were diagnosed in adulthood. A key factor distinguishing the two groups was the presence of maladaptive daydreaming, which was significantly more prevalent among adults diagnosed later in life.
The study revealed several critical insights:
Higher MD Scores in Late-Diagnosed ADHD Adults: Individuals diagnosed with ADHD in adulthood exhibited more severe ADHD symptoms and significantly higher MD scores compared to those diagnosed in childhood.
MD as a Predictor of Late ADHD Diagnosis: Statistical analysis indicated that MD severity was associated with an increased likelihood of receiving an ADHD diagnosis later in life, even when controlling for factors like education level, age, and ADHD medication use.
MD Masks ADHD Symptoms: The researchers propose that MD may obscure core ADHD traits, making it more difficult for individuals and professionals to recognize the disorder earlier. This delay in seeking mental health support may contribute to the underdiagnosis of ADHD.
MD Is Linked to Psychiatric Comorbidities: Among adults diagnosed with ADHD later in life, MD was strongly correlated with symptoms of depression, anxiety, and excessive mind-wandering.
Why Does Maladaptive Daydreaming Delay ADHD Diagnosis?
The study suggests two potential explanations for why MD might contribute to delayed ADHD diagnosis:
Masking ADHD Symptoms: MD may serve as a coping mechanism, temporarily reducing distress and creating a sense of control. This can make ADHD symptoms appear less obvious, especially in structured environments like school, where academic performance might not immediately raise concerns.
Reduced Externalizing Behaviors: Unlike hyperactivity and impulsivity, which often lead to earlier diagnosis, maladaptive daydreaming is an internalised behaviour. Individuals who experience MD may not exhibit disruptive symptoms that draw attention from teachers, parents, or clinicians, allowing their ADHD to go unnoticed for years.
Implications for Early ADHD Diagnosis and Effective Treatment
The findings highlight the importance of considering maladaptive daydreaming in ADHD assessments, particularly for individuals who present with inattentive symptoms. The study’s authors suggest that including MD in structured diagnostic interviews could help clinicians recognize ADHD cases that might otherwise be overlooked.
For individuals struggling with both ADHD and MD, treatment approaches should address both conditions.
Cognitive-behavioral therapy (CBT), mindfulness-based strategies, and stimulant medication for ADHD may help manage symptoms, but more research is needed to determine the most effective interventions for MD specifically.
Conclusion
This study adds to the growing body of research suggesting that ADHD is often underdiagnosed in adults, particularly those who develop coping mechanisms that mask their symptoms.
By recognizing maladaptive daydreaming as a potential factor in delayed ADHD diagnosis, clinicians can improve early detection and intervention strategies. Future longitudinal studies will be crucial in further exploring the relationship between ADHD and MD to ensure that individuals receive timely and effective support.
