Validity and reliability of the Polish Maladaptive Daydreaming Scale (PMDS-16) and its short form (PMDS-5).

Maladaptive daydreaming (MD) defines excessive use of fantasy, which replaces human interaction and/or interferes with academic, interpersonal, or vocational functioning. This study tests psychometric properties of the Polish version of the Maladaptive Daydreaming Scale (PMDS-16) and a short 5-item version derived from it (PMDS-5), and their capacity to screen for MD. The relationship between MD, resilience and the quality of life was also explored. Validity and reliability were examined in a sample of 491 participants in nonclinical (n = 315) and mixed-clinical (n = 176) groups who completed the tests online. The exploratory factor analysis with principal component analysis method of parameter estimation without rotation confirmed a one-factor solution of both instruments. Reliability of both versions was corroborated by Cronbach's alpha coefficient (PMDS-16: >.941; PMDS-5: >.931). The cutoff score maximizing sensitivity and specificity for MD was 42 in both instruments, but the short version had better discriminating properties. People who identified themselves as maladaptive daydreamers in comparison to those who did not had significantly higher scores in both instruments. Maladaptive daydreamers also had lower quality of life in the psychological and social relationships domains and poorer resilience. Both PMDS-16 and PMDS-5 proved to have satisfactory psychometric properties. They have similar psychometric properties, although PMDS-5 has better discriminating power and can be used effectively for the screening of MD.

Trapped Between Theological and Medical Notions of Possession: A Case of Possession Trance Disorder With a 3-Year Follow-Up.

Few studies on Possession Trance Disorder (PTD) describe diagnostic and research procedures in detail. This case study presents the clinical picture of a Caucasian Roman-Catholic woman who had been subjected to exorcisms because of her problems with affect regulation, lack of control over unaccepted sexual impulses, and somatoform symptoms accompanied by alterations in consciousness. It uses interpretative phenomenological analysis to explore meaning attributed by her to "possession" as a folk category and a medical diagnosis; how this affected her help-seeking was also explored. This study shows that receiving a PTD diagnosis can reinforce patients' beliefs about supernatural causation of symptoms and discourage professional treatment. Dilemmas and uncertainties about the diagnostic criteria and validity of this disorder are discussed.

Polish Catholics Attribute Trauma-related Symptoms to Possession: Qualitative Analysis of Two Childhood Sexual Abuse Survivors.

In many cultures, people use the concept of spirit possession to explain abrupt changes in behavior and identity or problems with affect regulation. High incidence of traumatic experiences are also found among "possession" victims but there are few studies exploring in detail their clinical presentations. This study reports the symptoms of two women with a history of sexual abuse, labeled in their religious communities as possessed, and subjected to exorcisms. Following a thorough clinical assessment, interpretative phenomenological analysis was used to explore their meaning-making and help-seeking behavior. Accepting the demonic reappraisal of trauma-related symptoms and interventions offered by clergy contributed to receiving social support but discouraged them from seeking diagnostic consultations and trauma-focused therapy, leading to their continued symptoms. This justifies the need for educating religious leaders in recognizing and understanding basic psychopathological symptoms.

Revisiting False-Positive and Imitated Dissociative Identity Disorder.

ICD-10 and DSM-5 do not provide clear diagnosing guidelines for DID, making it difficult to distinguish 'genuine' DID from imitated or false-positive cases. This study explores meaning which patients with false-positive or imitated DID attributed to their diagnosis. 85 people who reported elevated levels of dissociative symptoms in SDQ-20 participated in clinical assessment using the Trauma and Dissociation Symptoms Interview, followed by a psychiatric interview. The recordings of six women, whose earlier DID diagnosis was disconfirmed, were transcribed and subjected to interpretative phenomenological analysis. Five main themes were identified: (1) endorsement and identification with the diagnosis. (2) The notion of dissociative parts justifies identity confusion and conflicting ego-states. (3) Gaining knowledge about DID affects the clinical presentation. (4) Fragmented personality becomes an important discussion topic with others. (5) Ruling out DID leads to disappointment or anger. To avoid misdiagnoses, clinicians should receive more systematic training in the assessment of dissociative disorders, enabling them to better understand subtle differences in the quality of symptoms and how dissociative and non-dissociative patients report them. This would lead to a better understanding of how patients with and without a dissociative disorder report core dissociative symptoms. Some guidelines for a differential diagnosis are provided.

Delusions of Possession and Religious Coping in Schizophrenia: A Qualitative Study of Four Cases.

The notion of evil spirits influencing human behavior or mental processes is used in many cultures to justify various symptoms or experiences. It is also expressed in psychotic delusions of possession, but there is limited research in this area. This study explores how patients with schizophrenia came to the conclusion that they were possessed, and how this affected help-seeking. Interviews with two men and two women about their experiences and meaning-making were subjected to interpretative phenomenological analysis. Three main themes were identified: (1) Links between traumatic experiences and psychotic symptoms, (2) The emergence of religious themes in delusional contents, and (3) Reluctance to use medical treatment and instead to seek exorcism. In each case, attributing problems to possession was supported by the local environment and media, led to seeking spiritual help, and delayed diagnostic assessment and treatment. However, using religious coping contributed to the sense of predictability and social support. Clinicians are encouraged to explore the experiences and conflicts expressed by the symptoms which people ascribe to possession and to negotiate alternative explanatory models with their patients.

Maladaptive daydreaming as a new form of behavioral addiction.

BACKGROUND AND AIMS: Maladaptive daydreaming (MD) has many features of behavioral addiction, but research exploring this syndrome is limited. This case study provides a qualitative exploration of MD. METHODS: A structured clinical interview and mental state examination of a patient with MD were video-recorded and transcribed verbatim. Transcripts were subjected to the interpretative phenomenological analysis. RESULTS: MD was developed as a strategy to cope with distress but led to uncontrollable absorption in fantasy, social withdrawal, and neglecting aspects of everyday life. It was coupled with excessive Internet use and viewing porn. DISCUSSION AND CONCLUSIONS: Patients should be questioned about MD during clinical assessment. Further studies are necessary to determine whether MD constitutes a separate syndrome or is a part of other behavioral addictions.