Salomon-Small Gabrielle, Somer Eli, Harel-Schwarzmann Michal, Soffer-Dudek Nirit
The Consciousness and Psychopathology Laboratory, Department of Psychology, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
School of Social Work, University of Haifa, Haifa, Israel.
J Psychiatr Res. 2021 Apr;136:343-350. doi: 10.1016/j.jpsychires.2021.02.017. Epub 2021 Feb 15.
Maladaptive Daydreaming (MD) is a newly proposed mental disorder characterized by excessive, vivid fantasy activity impairing functioning. There is a high comorbidity of MD with Obsessive-Compulsive Spectrum Symptoms (OCSS), yet the mechanisms responsible for this relationship are still unclear. The present study set out to explore the relationship between MD and OCSS by: (1) examining dissociation, trauma, sense of control, and mind-wandering as potential mediators; (2) exploring whether MD is more strongly related to obsessions or compulsions; and (3) identifying patterns of specific obsessions and/or compulsions common in an MD sample. A group of 510 participants with self-identified MD completed a battery of online questionnaires. Dissociation and sense of control significantly mediated the MD-OCSS association. MD was moderately related to both obsessions and compulsions but was significantly more strongly related to the former. Frequently endorsed obsessions and compulsions among MD participants included checking and repetition compulsions, intrusive obsessions, and body-related obsessions and compulsions. We conclude that dissociative mechanisms, including dissociative absorption, play a major role in the relationship between MD and OCSS and may lead to consequent checking when transitioning back to reality, altered embodiment, intrusive images, and thoughts, and an impaired sense of mental control. Clinicians working with OCSS should be aware of the possible role of MD in the development or maintenance of symptoms. Future work should develop useful interventions for this type of shared psychopathology.
适应不良性白日梦(MD)是一种新提出的精神障碍,其特征是过度、生动的幻想活动损害了功能。MD与强迫谱系症状(OCSS)的共病率很高,但这种关系的机制仍不清楚。本研究旨在通过以下方式探索MD与OCSS之间的关系:(1)检查解离、创伤、控制感和走神作为潜在中介;(2)探索MD与强迫观念还是强迫行为的关系更强;(3)识别MD样本中常见的特定强迫观念和/或强迫行为模式。一组510名自我认定患有MD的参与者完成了一系列在线问卷。解离和控制感显著介导了MD与OCSS的关联。MD与强迫观念和强迫行为均呈中度相关,但与前者的相关性显著更强。MD参与者中经常出现的强迫观念和强迫行为包括检查和重复强迫行为、侵入性强迫观念以及与身体相关的强迫观念和强迫行为。我们得出结论,包括解离性沉浸在内的解离机制在MD与OCSS的关系中起主要作用,并且在回到现实时可能导致随之而来的检查行为、身体体验改变、侵入性图像和想法以及心理控制感受损。治疗OCSS的临床医生应意识到MD在症状发展或维持中的可能作用。未来的工作应针对这种类型的共同精神病理学开发有效的干预措施。