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While maladaptive daydreaming (MD) is not currently recognized as a psychiatric disorder, a new study suggests that the condition deserves more clinical attention. The researchers found that only about 20% of an ADHD sample met criteria for MD, suggesting that maladaptive daydreaming involves a unique form of inattention that makes it distinct from ADHD. The findings were published in the Journal of Clinical Psychology.

Maladaptive daydreaming is the act of immersing oneself in detailed, imaginative fantasies that consume one’s attention at the expense of everyday functioning. This type of daydreaming shares some overlap with symptoms of attention deficit hyperactivity disorder (ADHD), a condition involving difficulty maintaining attention.

However, the authors of the current study proposed a distinction between MD and ADHD. The researchers suggest that the daydreaming associated with ADHD is better described as mind wandering — the spontaneous shifting of attention to task-unrelated thoughts. Maladaptive daydreaming, on the other hand, is defined by daydreaming that is intentional, complex, and vivid. These distinctions are important because the two forms of daydreaming may have different underlying mechanisms and call for different treatment.

“In a previous study, we recruited about 40 people with MD and did a full clinical interview with each of them to identify if they meet criteria for any DSM-5 disorders, and if so, which. The most striking finding in that study was that they had overwhelming levels of clinical-level psychopathology: all participants met criteria for DSM-5 disorders, with most of them meeting criteria for more than one, often even three or four,” said study author Nirit Soffer-Dudek, a senior lecturer and head of The Consciousness and Psychopathology Laboratory at Ben-Gurion University of the Negev.

“In addition, we found that 77% of the sample met criteria for ADHD, most of them to the inattention only type (without hyperactivity). Spontaneously in the interview they explained that their difficulty concentrating on tasks was a result of their addiction to fantastical daydreaming. Thus, we began to view meeting criteria for ADHD as a secondary result of MD.”

“Moreover, we came to view this supposed ‘comorbidity’ not as a true comorbidity but rather as inaccurate labeling. Specifically, it seemed that if MD were a formal diagnostic syndrome, the label of ADHD would be superfluous for these people (because the symptoms seemed to be better explained by MD in their cases). We assumed that having MD leads to meeting criteria for ADHD, but not necessarily vice versa.”

For their new study, Soffer-Dudek and her colleagues aimed to investigate whether MD is a distinct mental phenomenon from ADHD by examining rates of MD among people with ADHD. While studies have found high rates of ADHD among people with MD, if the two constructs are independent, people with ADHD will not have similarly high rates of MD.

A group of 98 people with ADHD completed online questionnaires that assessed ADHD symptoms, several measures of psychological distress, and maladaptive daydreaming. Of these participants, 59 had elevated MD scores and were contacted to undergo a clinical interview to assess MD. After 44 of these participants responded and were interviewed, 17 met criteria for MD. Accounting for selective dropout, this means that roughly 20-23% of the full sample of ADHD participants also met criteria for MD.

Notably, this rate of MD in an ADHD sample is far smaller than the previously reported incidence of ADHD in an MD sample, which was around 77%. This suggests that the two constructs are distinct, with MD involving unique characteristics that are not explained by ADHD.

The study authors suggest that maladaptive daydreaming is better described as a dissociative disorder or behavioral addiction, rather than an issue of attention. They suggest that MD is an “independent mental phenomenon, which often creates a deficit in attention as a side effect, causing MDers in some cases to also meet criteria for ADHD, but not necessarily vice versa.”

Participants who met criteria for both ADHD and MD had higher depression and loneliness, and worse self-esteem. These heightened symptoms of distress were not explained by ADHD symptom severity, suggesting a unique contribution of MD.

The researchers note the importance of distinguishing between the two conditions. “There are many reasons why people may find it hard to focus,” Soffer-Dudek told PsyPost. “The ADHD diagnosis is a bit broad in that it looks mainly at the end result, and not on the inner dynamic of thought leading to that result. We suggest that different thought dynamics should be treated differently.”

“If your ADHD stems from general mind-wandering with ever-changing distractions (which is characteristic of typical ADHD), you may need different treatment than if you find yourself compulsively drawn to engage in elaborate, narrative, vivid and highly emotional fantasies (characteristic of MD). If it is the latter, we suggest seeking psychological help, and introducing to the clinician the concept of MD, which has been researched extensively in the past years, but is still quite unknown.”

Along similar lines, many people with MD have called for better recognition of the construct of maladaptive daydreaming, expressing that the existing psychological definitions do not adequately capture the depth of their experiences. While further study is needed to confirm whether MD should be considered a psychiatric disorder, it could be that some people with an ADHD diagnosis would be better served by a diagnosis of MD.

“If someone has fanciful immersive daydreams but does not experience them as a problem, then that would not count as MD, and is not a problem,” Soffer-Dudek noted. “Our aim is not to pathologize normal daydreaming. MD describes a situation where the person feels that their addiction to daydreaming is impairing their lives (e.g., loneliness, difficulties concentrating due to daydreaming, or difficulty creating or maintaining relationships because it is easier and more rewarding in the short run to daydream them).”

“Many MD communities exist online (e.g., Facebook, Reddit) offering peer support,” Soffer-Dudek added. “Also, we have a website dedicated to the research of MD, where people who see themselves as suffering from MD can register to get news updates on the topic and be offered to participate in research.”

The researchers are currently seeking participants for a new study. “We are looking for people who have been diagnosed as suffering from ADHD (they don’t have to be maladaptive daydreamers),” Soffer-Dudek said. Information about the new study can be found here: https://bgupsych.eu.qualtrics.com/jfe/form/SV_2lQVt6a2JKLFzD0

The study, “Could immersive daydreaming underlie a deficit in attention? The prevalence and characteristics of maladaptive daydreaming in individuals with attention‐deficit/hyperactivity disorder”, was authored by Nitzan Theodor‐Katz, Eli Somer, Rinatya M. Hesseg, and Nirit Soffer‐Dudek.

Are video games the future of treatment for children on the autism spectrum? A study published in the Journal of Autism and Developmental Disorders suggests they could be. Video game-based interventions may be a cheap, easy, and effective alternative to face-to-face treatment.

Many people on the autism spectrum have trouble with social skills, which can lead to adverse effects including isolation and social rejection. This can put them at a higher risk for anxiety and depression. Interventions often consist of building social skills, which can utilize a myriad of techniques. Previous research has experimented with using video games as a tool for this type of intervention but did not have a control group. This study seeks to address limitations of past research and expand the literature on this topic.

Renae Beaumont and colleagues utilized a sample of 7- to 12-year-old children in Queensland with Autism Spectrum Disorder. Participants had to refrain from other treatment during the duration of the study. Seventy children participated, including 60 boys and 10 girls. They were randomly assigned to either the social skills video game condition or the control condition, which was a similar video game without any social or emotional skill component. (The social skills video game is called Secret Agent Society.)

Parents were asked to rate their children on social skills, emotional regulation, behavior, anxiety, and also rate their satisfaction with the program. Participants completed 10 weeks of their program and completed post-trial measures. Six weeks later they completed follow-up measures.

Results showed that the social skills intervention was successful, with the children in that condition showing significantly larger improvements in their social and emotional skills. These positive results were maintained during follow-up a month and a half later. Parents of children in the control condition noted improvements as well, but not as much as in the experimental condition. This could be due to the increased time spent with the children. The results did not show any significant effects of the intervention on the children’s anxiety but did show a reduction in behavioral issues.

Though this study took strides into understanding if video game-based social and emotional treatment is effective, it also has limitations. Firstly, the parents were the raters and are susceptible to bias. This is shown by the improvements perceived by parents of children in the control group. Additionally, there was a very uneven gender split in the sample, which could lead to skewed results.

“There continues to be a pressing need for innovative social skills supports for children on the autism spectrum, and computer-based remoted delivery may be a viable option,” the researchers concluded. “Such interventions are even more critical during global crises such as COVID-19, where there has been a desperate need for evidence-based remote therapies that can be effectively provided without the risk of in-person contact. The use of supported videogame-based child interventions has the potential to significantly improve the affordability and accessibility of intervention services.”

The study, “Randomized Controlled Trial of a Video Gaming-Based Social Skills Program for Children on the Autism Spectrum“, was authored by Renae Beaumont, Hugh Walker, Jonathan Weiss, and Kate Sofronoff.

Drinking coffee may reduce your risk of Alzheimer’s disease, according to findings published in the journal Frontiers in Aging Neuroscience. The study followed a sample of older adults for 10 years and found that those who consumed more coffee showed slower cognitive decline, slower Aβ-amyloid accumulation, and a lower likelihood of Alzheimer’s disease.

Alzheimer’s disease (AD) is a form of dementia that involves progressive memory loss and cognitive decline. This neurodegeneration is believed to be caused by a build-up of a protein called Aβ-amyloid that causes inflammation in the brain. Scientific studies have uncovered promising evidence that coffee consumption might lower the risk of Alzheimer’s, but there has been minimal longitudinal research on this topic.

“Worldwide, a high proportion of adults drink coffee daily, making it one of the most popular beverages globally. In the absence of effective disease-modifying treatments for Alzheimer’s disease, our research is looking at modifiable risk factors that could delay the onset of the disease,” said study author Samantha L. Gardener of Edith Cowan University. “Even a 5-year delay would have a massive social and economic benefit, and these dietary modifications are generally accessible to all as well as being less expensive than medications and with less side effects.”

Gardener and her team examined longitudinal data from a larger study called the Australian Imaging, Biomarkers and Lifestyle study of ageing (AIBL). A sample of 227 older adults who were an average of 69 years old at baseline completed questionnaires that included a question on their coffee drinking habits.

The participants also completed a battery of questionnaires that assessed six cognitive domains — episodic recall memory, recognition memory, executive function, language, attention and processing speed — as well as the AIBL Preclinical Alzheimer Cognitive Composite (PACC). These cognitive assessments were completed at baseline and then again on up to seven different occasions across a 10-year period.

Throughout the 10 years, a subset of participants also underwent multiple magnetic resonance imaging (MRI) scans to measure brain volume changes and Positron Emission Tomography (PET) scans to assess Aβ-amyloid accumulation. These scans were also taken on up to seven different occasions.

The findings revealed that the participants who drank more coffee showed slower cognitive decline throughout the 10 years in the domains of executive function and attention. They also showed slower decline according to the AIBL PACC. Participants who drank more coffee were also less likely to transition from their “cognitively normal” status at baseline to a “mild cognitive impairment” or “AD” status throughout the study period.

An analysis of the PET scans further revealed that drinking more coffee was associated with slower Aβ-amyloid accumulation in the brain and a lower risk of reaching “moderate”, “high”, or “very high” Aβ-amyloid burden status. The MRI scans revealed that coffee intake was not related to brain volume atrophy.

These results suggest that coffee intake might protect against cognitive decline by slowing down the build-up of Aβ-amyloid in the brain, and improving “the associated neurotoxicity from Aβ-amyloid-mediated oxidative stress and inflammatory processes.” These results suggest that habitual coffee intake might serve as a lifestyle factor that can delay the onset of Alzheimer’s.

“Our estimates suggest that if the average cup of coffee made at home is 240 g, increasing intake from one to two cups per day could provide up to 8% decrease in executive function decline over an 18-month period, and up to 5% decrease in cerebral Aβ-amyloid (the sticky protein that clumps together in the brain, killing neurons, in Alzheimer’s disease) accumulation over the same time period,” Gardener told PsyPost. “However, finding a maximum number of beneficial cups of coffee is a question for future research which we were not able to identify in the current study. Unfortunately, there will be a limit whereby more cups will not produce any further positive effects.”

“Any future recommendations would also have to be personalized to the individual taking into consideration any other medical conditions they have that may make increasing coffee consumption not advisable,” Gardener added.

The researchers also noted that additional evidence from longitudinal intervention studies would be needed to corroborate these findings. While the study authors say it is unclear which coffee ingredient is responsible for these neuroprotective effects, they suggest that the answer may be more than caffeine. For example, a study in rats found evidence of neuroprotective benefits from a component of coffee called Eicosanoyl-5-hydroxytryptamide (EHT).

“Additional studies with participants followed for 10+ years in a range of different groups of participants, and intervention studies where participants are assigned a specific amount and type of coffee to drink are required to validate our findings and confirm our preliminary findings,” Gardener explained.

“Our study did not have data on mid-life coffee consumption, consequently potential positive or negative effects of coffee intake at midlife cannot be assessed in the current study. It was also not possible for us to determine the potential consequences of varying methods of coffee preparation (e.g., decaffeinated coffee, brewing method, with or without milk or sugar etc.) on the associations observed, so these are both major methodological points to include in future research.”

The study, “Higher Coffee Consumption Is Associated With Slower Cognitive Decline and Less Cerebral Aβ-Amyloid Accumulation Over 126 Months: Data From the Australian Imaging, Biomarkers, and Lifestyle Study”, was authored by Samantha L. Gardener, Stephanie R. Rainey-Smith, Victor L. Villemagne, Jurgen Fripp, Vincent Doré, Pierrick Bourgeat, Kevin Taddei, Christopher Fowler, Colin L. Masters, Paul Maruff, Christopher C. Rowe, David Ames, Ralph N. Martins, and the AIBL Investigators.

People who support Christian nationalism in the United States tend to perform worse on a test of religion’s role in American history, according to new research published in the Journal for the Scientific Study of Religion.

“There’s been a fairly large amount of research on conservative Christians (particularly those influenced by the Christian Right, like white evangelicals) and their views of science or their knowledge about basic scientific facts,” said Samuel L. Perry (@socofthesacred), an associate professor of sociology at the University of Oklahoma and the corresponding author of the study.

“Research has consistently shown that conservative Christians tend to score lower on, say, brief science quizzes than other Americans. However, research also shows this isn’t necessarily because they’re less intelligent or even ignorant about what the ‘right’ answer is. Rather their response patterns suggest that they are answering particular scientific questions according to their theology.”

“For example, conservative Christians don’t tend to score lower on science questions that are religiously uncontested, like questions about lasers, atoms, or viruses,” explained Perry, the author of The Flag and the Cross. “But when you ask them about ‘the Big Bang’ or ‘evolution’ or even continental drift, they score lower because they reject the scientific consensus on those questions.”

“Related to this, we’ve found that Christian nationalist ideology is a powerful predictor of this kind of response patterning on science quizzes. Americans who more strongly affirm Christian nationalism score roughly the same as other Americans on uncontested science questions, but Christian nationalism is the strongest predictor that Americans get the contested questions wrong.”

The researchers analyzed the responses from a nationally representative sample of 1,378 American adults who had participated in the Public and Discourse Ethics Survey. As part of the survey, the participants were asked to respond to five true/false statements about religion in American political history.

The participants were also asked the extent to which they agreed with statements such as “The federal government should declare the United States a Christian nation” and “The success of the United States is part of God’s plan” — which the researchers used as a proxy for support for Christian nationalism.

Perry and his colleagues found that people who scored lower on the brief American history quiz tended to be more supportive of Christian nationalism. Interestingly, when they removed “I don’t know” responses from their analysis, the researchers found that the negative relationship between historical knowledge and Christian nationalism strengthened, suggesting that support for Christian nationalism is associated with “intentionally affirming factually incorrect statements.”

“We found that even after we accounted for Americans’ religious, political, and demographic characteristics, those who more strongly affirmed Christian nationalism were more likely to belief false things about religion’s place in American history,” Perry told PsyPost. “They were more likely to believe, for example, that the US Constitution references our country’s obligations to God several times (it does not), that the First Amendment says Congress could make laws privileging Christianity (it does not), or that the Supreme Court made it illegal to pray or read your Bible in public schools (it did not).”

“We also show this isn’t necessarily connected to lack of education or lack of confidence in one’s answers. In fact, we show that the more Americans affirm Christian nationalism, they’re more likely to give confident wrong answers. That suggests there’s something ideological going on here. Americans who believe Christianity should have a more central role in American society today tend to reinterpret history with that in mind.”

The researchers controlled for a number of factors, including education, age, race, family income, geographic region, party identification, religious identification, and religiosity. But as with any study, the research includes some caveats.

“One issue that we are not able to answer definitively is whether the connection between Christian nationalist ideology and incorrect views of history is due primarily to ideology or the sort of information such Americans have been receiving,” Perry explained. “There’s actually a fairly robust ‘Christian nationalism industrial complex’ that supplies Study Bibles, Bible studies, video series, sermon materials, and scores of books dedicated to teaching this history of America as a ‘Christian nation.'”

“It could be that Americans who score higher on Christian nationalism have assimilated such material and are answering accordingly. Alternatively, it could be more that Americans who embrace Christian nationalist ideology are simply answering with what ‘feels’ right. We need to disentangle this.”

The study, “Historical Fundamentalism? Christian Nationalism and Ignorance About Religion in American Political History“, was authored by Samuel L. Perry, Ruth Braunstein, Philip S. Gorski, and Joshua B. Grubbs.