Can Mindfulness and Self-monitoring Improve Control Over Maladaptive Daydreaming?

Not Applicable

Completed

• Conditions: Internet-Based Intervention; Psychological Intervention; Intervention Study
• Interventions: Other: Online therapeutic intervention for maladaptive daydreaming based on mindfulness; Other: Online therapeutic intervention for maladaptive daydreaming based on mindfulness and self-monitoring

• Registration Number: NCT05235243
• Lead Sponsor: University of Haifa

Brief Summary

Maladaptive daydreaming (MD) is a compulsive form of daydreaming that causes distress and functional impairment among tens of thousands of self-diagnosed sufferers. This is the first controlled treatment trial for MD. The investigators built an internet-based self-help program for MD and tested the effectiveness of mindfulness and self-monitoring in improving control over MD, comparing three groups across three measurement points in time.

Detailed Description

Objective: Maladaptive daydreaming (MD) is a compulsive form of daydreaming that causes distress and functional impairment among tens of thousands of self-diagnosed sufferers. This is the first controlled treatment trial for MD. Method: The investigators built an internet-based self-help program for MD and tested the effectiveness of mindfulness and self-monitoring in improving control over MD, compared to internet-based support as usual (waiting-list group). Participants were randomly assigned to three groups and measured across three points in time (baseline, post-intervention, and 6 months follow-up). The investigators measured the change in daydreaming pathology (MDS-16), daydreaming frequency (DDFS), and daydreaming functioning (DWSAS), alongside changes in psychiatric symptoms (BSI), and intervention outcome (OQ). Changes in mindful attention and awareness skills, compliance with program requirements, and feedback to the program were also measured.

Study Timeline

• Study Start: 2018-12-20
• Primary Completion: 2020-02-03
• Study Completion: 2021-02-28
• Study First Submitted: 2022-01-19
• Status Verified: 2022-02
• Study First Submitted QC: 2022-02-09
• Last Update Submitted: 2022-02-09
• Study First Posted: 2022-02-11
• Last Update Posted: 2022-02-11

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 697

Inclusion Criteria

• Age above 18 years
• MD diagnosis
• Not being in any concurrent treatment for MD
• English fluent
• Daily access to the internet, and to a device with internet access
• Give informed consent to the study
• Respondents who reported being on a stable dose of medication for at least three months could take part in the study provided that they did not change their dosages while participating in the study.

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Exclusion Criteria

• Age under 18 years
• No MD diagnosis
• In concurrent psychology therapy for MD
• Not fluent in English
• Not having a daily internet access
• Taking medication for less than three months

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
The partial intervention (PI) group	Online therapeutic intervention for maladaptive daydreaming based on mindfulness	The partial intervention (PI) group received an intervention identical to the FI group (a psycho-education module about MD and its addictive behavior mechanism, a motivation enhancement module based on motivational interviewing, mindfulness modules) with the exclusion of the self-monitoring modules.
The Full Intervention (FI) group	Online therapeutic intervention for maladaptive daydreaming based on mindfulness and self-monitoring	The full intervention (FI) group received a psycho-education module about MD and its addictive behavior mechanism, a motivation enhancement module based on motivational interviewing, mindfulness modules, and self-monitoring modules.

Primary Outcome Measures

Name	Time	Method
Change from baseline in maladaptive daydreaming	Baseline, post, and follow-up (8 month total)	Change in the 16-item Maladaptive Daydreaming Scale (MDS-16) compared to baseline, measured 2 months and 6 months post-intervention. The MDS-16 is the primary self-report scale that gauges maladaptive daydreaming on a 10-point Likert scale. Scores range from 0 to 100, with the mean score of 40 set as an evidence-based cut-off score for clinical-level MD. Higher scores indicate an elevated level of maladaptive daydreaming, hence, a worse outcome.
Change from baseline in daydreaming frequency	Baseline, post, and follow-up (8 month total)	Change in the Daydreaming Frequency Scale (DDFS) compared to baseline, measured 2 months and 6 months post-intervention. The DDFS is a 12-item subscale of the Imaginal Processes Inventory, gauging reported daydreaming frequency. Items are marked on a 5-point Likert scale. Scores range from 12 to 60. Higher scores indicate an elevated frequency of daydreaming, hence, a worse outcome.
Change from baseline in work and social adjustment	Baseline, post, and follow-up (8 month total)	Change in the Daydreaming Work and Social Adjustment Scale (DWSAS) compared to baseline, measured 2 months and 6 months post-intervention. The DWSAS is a 6-item measure assessing adjustment and disfunction in relation to daydreaming. Items are ranked on a 9-point Likert scale ranging from 0 to 8. The DWSAS scores range from 0 to 48. A score of 12 or lower indicates "no pathology and disfunction". Scores between 12 and 24 indicate "pathology and impaired function", while scores of 24 or above suggest "severe pathology and impaired function".

Secondary Outcome Measures

Name	Time	Method
Change from baseline in psychiatric symptoms	Baseline, post, and follow-up (8 month total)	Change in the Brief Symptom Inventory (BSI) compared to baseline, measured 2 months and 6 months post-intervention. The BSI is a 53-item scale rated on a 5-point Likert scale of general psychopathology. The BSI is divided into nine subscales: somatization, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, psychoticism, and four additional items. The BSI total score ranges from 0 to 4. Higher scores suggest elevated psychopathology, hence, a worse outcome.
Change from baseline in intervention outcome	Baseline, post, and follow-up (8 month total)	Change in the Outcome Questionnaire (OQ) from baseline, measured 2 months and 6 months post-intervention. The OQ is a 45-item scale evaluating the quality of mental health care and its outcome featuring three sub-scales: subjective discomfort, interpersonal relations, and social role performance. The OQ scores range from 0 to 180. Higher scores indicate a worse outcome.

Trial Locations

Locations (1)

University of Haifa; 🇮🇱 Haifa, Israel