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Abstract：
Maladaptive daydreaming (MD) is an immersive fantasy activity that leads to distress and socio-occupational dysfunction. MD has many features suggestive of behavioural addiction, but research exploring the phenomenology of this clinical construct is limited. MD has also been purported to be a maladaptive strategy to cope with distress, but often leads to uncontrollable absorption in fantasy world, social withdrawal and neglected aspects of everyday life. In this paper, we report the case of a 16-year-old boy who developed internet gaming disorder and MD after experiencing cyberbullying from his peers. The patient engaged in vivid, fanciful imagery that lasted for hours, leading to social dysfunction and academic deterioration. Baseline assessment revealed a Maladaptive Daydreaming Scale-16 score of 65 (cut-off 50) and an Internet Gaming Test-20 score of 86 (cut-off 71). The patient was managed primarily with psychological intervention. The therapy focused on behaviour modification and cognitive restructuring. Patients in clinical setting should be questioned about MD when presenting with excessive use of technology or other forms of behavioural addictions. Further studies are necessary to determine the biopsychosocial factors of MD and its correlates. There is also a need to study treatment and management approaches for treating MD.
摘要：
适应不良的白日梦（MD）是一种身临其境的幻想活动，会导致痛苦和社会职业功能障碍。MD有许多暗示行为成瘾的特征，但是探索这种临床结构现象学的研究是有限的。MD也被认为是一种应对困境的不适应策略，但经常导致幻想世界中无法控制的吸收，社会退缩和日常生活中被忽视的方面。在本文中,我们报告了一个16岁男孩的案例，他在经历了同龄人的网络欺凌后患上了网络游戏障碍和MD。病人从事生动，持续数小时的幻想图像，导致社会功能障碍和学业恶化。基线评估显示，适应不良的白日梦量表16得分为65（截止值50），互联网游戏测试20得分为86（截止值71）。患者主要接受心理干预。该疗法侧重于行为矫正和认知重构。当过度使用技术或其他形式的行为成瘾时，应向临床环境中的患者询问MD。需要进一步的研究来确定MD的生物心理社会因素及其相关因素。还需要研究用于治疗MD的治疗和管理方法。
