Diagnostics
Description:
The MDS is the most essential instrument for assessing maladaptive daydreaming—an overview of its structure, application, and significance, as well as other test instruments for research and practice.
Related
Teaser (Lead):
How do you measure a phenomenon that has not yet been officially recognised? The Maladaptive Daydreaming Scale (MDS) is the primary research instrument for quantifying the extent, intensity, and consequences of maladaptive daydreaming. This article introduces the scale, explains its structure and application, and shows why it is indispensable for research and practice—despite its limitations.
Diagnosis of maladaptive daydreaming - the Maladaptive Daydreaming Scale (MDS) and more research
First, read the detailed main article [Understanding, treating and overcoming maladaptive daydreaming - a comprehensive guide]
or
The overview "Maladaptive daydreaming - causes, symptoms and help". This topic article explains how MDS works and why it is essential for research and practice.
1 Why there is no official diagnosis - and yet MDS is essential
Maladaptive daydreaming is not currently recognised as a separate disorder in any standard diagnostic system, such as the DSM-5 or ICD-11. The term originates from research and has yet to be widely recognised. One of the reasons for this is that the symptoms overlap with other disorders (ADHD, obsessive-compulsive disorder, dissociative disorders), and there have been comparatively few systematic studies to date.
This is precisely where the Maladaptive Daydreaming Scale (MDS) comes in: It was developed to enable the recording of the phenomenon in a standardised way and to study it scientifically, despite the lack of official recognition.
2 Origin and development of the MDS
Eli Somer and his team developed the MDS in the early 2010s. Previously, there were only qualitative descriptions and individual case reports from those affected. The scale made it possible for the first time to record maladaptive daydreaming in a standardised way and to compare it in larger samples. This made it possible to show that MD is an independent pattern - and not just a side effect of ADHD, depression or trauma.
3 Structure: MDS-16 and MD-SF5
The MDS-16 consists of 16 items that measure daydreaming in several dimensions. It is scored on a scale from 0 ("never") to 100 ("extreme "). The questions relate to:
- Frequency: how often do daydreams occur during the day or week?
- Duration: How many minutes or hours do they last?
- Loss of control: How difficult is it to stop or interrupt the fantasy?
- Emotional intensity: How vivid, realistic and emotional are the scenes?
- Functional impairment: What impact do they have on work, school, relationships or sleep?
In addition to the full version, there is also the MDS-SF5 (Maladaptive Daydreaming Scale Short Form), a short form with five core questions. It is mainly suitable for screening in larger studies or as an initial orientation in everyday clinical practice.
4. structured interviews: The SCIMD
The Structured Clinical Interview for Maladaptive Daydreaming (SCIMD) is also available for clinical studies. This is a semi-structured interview conducted by trained professionals. The SCIMD is based on the diagnostic criteria proposed by researchers, such as the intensity and duration of daydreams, loss of control, and distress. The procedure is designed to ensure that the interview is comprehensive and standardised.
5 Application in research and practice
Research:
The MDS is used internationally to determine prevalence rates, investigate causes and analyse correlations with comorbidities such as ADHD, obsessive-compulsive disorder or post-traumatic stress. Without the scale, today's figures on the prevalence of MD would be inconceivable.
Clinical practice:
Although MD is not an official diagnosis, some psychotherapists use the MDS to record the severity of suffering, document the course of therapy or make progress measurable.
Self-tests:
Online versions of the MDS provide those affected with initial guidance. They can raise awareness of one's own behaviour, but are in no way a substitute for a professional diagnosis.
6 Strengths and limitations of the MDS
Strengths:
- First reliable way to systematically record MD
- International translations, thus cross-cultural comparability
- High reliability and validity in studies
- Helpful for self-reflection and clinical assessment
Limitations:
- Not an official diagnostic tool, as MD is not included in the DSM-5 or ICD-11
- Dependence on subjective self-assessment (distortions possible)
- Not sufficient on its own: results should always be supplemented by clinical interviews
- Risk of misuse due to pure self-diagnosis without professional categorisation
7. self-observation vs. professional diagnostics
Self-tests can provide helpful orientation, but they are no substitute for a medical or psychotherapeutic assessment. High values in the MDS-16 or MD-SF5 do not automatically indicate the presence of a pathological disorder; low values do not necessarily rule it out. It is essential to consider the subjective suffering and the impairment in everyday life.
8 Outlook and future of MDS
MDS has revolutionised the field of MD research. For the first time, it has made it possible to visualise the phenomenon and investigate it in a scientifically tangible way. In the future, the scale could be
- be further developed (e.g. MDS-20 or extended clinical versions),
- be used in combination with interviews such as the SCIMD to increase diagnostic certainty,
- and serve as the basis for a possible official diagnosis in DSM or ICD.
Should MD one day be formally recognised, the MDS is likely to remain a central component of diagnosis.
Conclusion
The Maladaptive Daydreaming Scale is more than just a questionnaire; it is a milestone in the research of an elusive phenomenon. For those affected, it offers orientation; for researchers, it provides reliable data; and for therapists, it is a valuable tool for visualising the severity of MD.
Nevertheless, anyone who feels that daydreaming is dominating their life should seek professional help. Psychiatrists and psychotherapists can assess whether other disorders are present, determine the role daydreaming plays, and identify suitable treatment approaches. Without the MDS, maladaptive daydreaming would hardly be so clearly defined today.