This article delves into the possible connection between autism spectrum disorder (ASD) and maladaptive daydreaming (MD).
Through the analysis of a study conducted by West and colleagues on two samples (individuals diagnosed with autism and individuals who identify with MD), it emerges that 43% of autistic individuals meet the diagnostic criteria for MD, while only 12% of probable MD individuals meet the criteria for autism.
The commonalities between the two conditions are then highlighted, such as loneliness, emotional regulation difficulties, and the presence of repetitive motor movements. However, imaginative abilities can vary significantly among autistic individuals. The hyper-focus characteristic of autism can also involve multiple interests, unlike MD, which primarily involves fantasizing.
Therefore, while there are some similarities, the two conditions also present significant differences in the mode and content of imagination.
The information presented in this article is largely drawn from the free scientific dissemination page of The International Consortium for Maladaptive Daydreaming Research (ICMDR).
What is Autism?
Autism spectrum disorders are a group of neurodevelopmental disorders characterized by:
- Hyperfocus on restricted interests: Individuals with autism often have a strong and persistent interest in a particular topic or activity. They may spend a lot of time and energy learning about and engaging with their interests, even to the exclusion of other activities.
- Repetitive behaviors and stereotypies: Repetitive behaviors are actions that are repeated over and over again, often in a way that is not typical or socially appropriate. Stereotypies are repetitive movements or mannerisms, such as rocking, hand flapping, or twirling.
- Difficulties with language and communication: Individuals with autism may have difficulty understanding and using language in a way that is typical for their age. They may also have difficulty with social communication, such as making eye contact, understanding nonverbal cues, or engaging in back-and-forth conversations.
- Social interaction challenges: Individuals with autism may have difficulty forming and maintaining relationships, and they may experience social isolation and loneliness.
What Scientific Research Tells Us About Autism and Maladaptive Daydreaming
A study conducted by West and colleagues (2022) investigates the comorbidity between ASD and MD. Two different samples were analyzed: a sample of people on the autism spectrum and a sample of probable MDers. The results showed that:
- 43% of autistic people meet the proposed diagnostic criteria for maladaptive daydreaming,
- 12% of people with MD meet the criteria for autism spectrum disorder.
This means that it is much more common for people diagnosed with ASD to also exhibit typical MD behaviors, while it is more difficult for MDers to fall within the ASD diagnosis.
However, both this study and subsequent research have shown how imaginative abilities can vary greatly in autistic individuals. The immersive daydreaming experience occurs in people with ASD if it is accompanied by loneliness, emotional regulation difficulties, and repetitive movements. In fact, without these variables, ASD correlates negatively with the MD experience, suggesting less daydreaming activity in general. This confirms several studies that have highlighted how the imaginative abilities of ASD are limited.
The strongest connection between ASD and MD is, therefore, found in the aspects of loneliness, difficulty in emotional regulation, and the presence of repetitive movements. In cases where both conditions are present, there is a greater level of difficulty in these areas.
The results of the study show how MD could arise as a coping strategy for particularly imaginative people facing the typical challenges of ASD, such as difficulties in communication, social interaction, hypersensitivity, and difficulty adapting to new situations.
However, it is still unclear whether MD develops in autistic people precisely because of these difficulties or whether, instead, these discomforts may be a consequence of a continuous withdrawal from reality.
ASD and MD: Similarities and Differences
As we have seen, both MD and ASD share some common elements, but what are the differences?
The Use of Daydreaming
Several studies suggest that in ASD, there is a tendency to use immersive imagination not so much to satisfy the need for interpersonal relationships, as is the case for MD, but rather to process information, for example, to understand sentences and solve perceptual puzzles. Imaginative experiences in ASD allow individuals to be creative and process information in a mental space, away from the pressures of real social interactions and expectations. Daydreaming can, therefore, offer a safe and predictable space to explore emotions, social scenarios, and identity.
Repetitive Movements
Another important aspect is repetitive movements. Motor stereotypy is a repetitive behavior associated with autism and can involve different parts of the body.
In the case of MD (without ASD), repetitive movements are limited to the daydreaming experience, and, unlike other disorders that include repetitive motor movements, in MD, there is no difficulty in blocking motor movements. It is the desire to immerse oneself in fantasy that turns out to be uncontrollable. Some people with MD report using stereotypic repetitive movements (e.g., rocking, spinning, walking) during fantasy to induce and maintain the emotional intensity typical of deep immersion. The movement may correspond to the level of emotional investment required by the fantasy.
Hyperfocus
In the case of ASD, there is a tendency to be strongly involved in specific interests, which can be very intense. This can result in difficulty interrupting the activity on which one is focused and can cause interference with other activities. The immersion is so intense that it involves a decrease in self-awareness and awareness of the environment and is sometimes described as “hyperfocus.”
This characteristic has similarities with what happens during episodes of immersive and deep imagination typical of MD. People with MD not only report that fantasizing interferes with other daily activities, but they also have difficulty interrupting it. When interruption becomes inevitable due to external factors, it can cause a sense of anxiety.
Unlike MD, hyperfocus in ASD can also involve activities other than fantasizing.
Finally, it is rare for people with MD (without ASD) to report being particularly interested in specific objects or textures or the need to keep routines, clothes, meals, furniture, etc. always unchanged.
Conclusions
Based on the information available to date, it is possible to highlight how the common elements between maladaptive daydreaming and autism spectrum disorders can be identified in three main aspects:
- Loneliness: Both individuals with MD and ASD often experience loneliness and social isolation. They may have difficulty forming and maintaining relationships, and they may feel misunderstood or excluded by others.
- Emotional regulation difficulties: Both individuals with MD and ASD may struggle to regulate their emotions. They may experience intense emotions, such as anger, sadness, or anxiety, and they may have difficulty coping with these emotions in a healthy way.
- Repetitive motor movements: Both individuals with MD and ASD may engage in repetitive motor movements, such as rocking, hand flapping, or twirling. These movements may be a way of self-stimulation or a way of coping with anxiety or stress.
Another important element that emerges is the great variability of imaginative abilities in ASD. The heterogeneity with which MD manifests itself in the ASD population makes investigating specific modalities, content, and purposes of fantasies more complex.
The aspects that are more easily recognizable as differences between ASD and MD (in the case where only one is present present) concern the area of interest. If in ASD, hyperfocus and specific interests can be directed towards multiple objects or activities, in the case of MD, the manifestations of these behaviors are limited to the activity of daydreaming.
Further studies are still needed to clarify the relationship between autism and maladaptive daydreaming.