The Structured Clinical Interview for Maladaptive Daydreaming

The Structured Clinical Interview for Maladaptive Daydreaming (SCIMD) is a diagnostic interview specifically crafted to identify the existence and intensity of maladaptive daydreaming (MD).

Comprising ten primary or ‘probe’ questions, the SCIMD evaluates different facets of the condition.

Following each of these core questions, the interviewer poses additional queries and delves deeper into the patient’s symptoms, aiming to gather sufficient information for assessment.

The Structured Clinical Interview for Maladaptive Daydreaming

The SCIMD was developed in 2017 by four authors: leading maladaptive daydreaming researchers Eli Somer and Nirit Soffer-Dudek, experienced mental health clinician Naomi Halper, and researcher Colin Ross, who has been involved in the development of numerous other widely-used diagnostic measures.

Contents of the SCIMD

The ten questions featured in the interview are designed to assess MD symptoms against diagnostic criteria developed at the same time and is based on the authors’ conversations with thousands of individuals who described themselves as maladaptive daydreamers when developing the MD scale.

The diagnostic criteria follows the format used in the DSM-V, one of the main handbooks used to diagnose mental health disorders around the world. The criteria are the following:

A. Persistent and recurrent fantasy activity that is vivid and fanciful, as indicated by the individual exhibiting two (or more) of the following in a 6-month period; at least one of these should be Criterion 1

1. While daydreaming, experiences an intense sense of absorption/immersion that includes visual, auditory, or affective properties
2. Daydreaming is triggered, maintained, or enhanced with exposure to music
3. Daydreaming is triggered, maintained, or enhanced with exposure to stereotypical movement (e.g., pacing, rocking, or hand movements)
4. The individual often daydreams when feeling distressed or bored
5. Daydreaming length or intensity intensifies in the absence of others (e.g., daydreams more when alone)
6. The individual is annoyed when unable to daydream or when daydreaming is interrupted or curbed
7. The individual would rather daydream than engage in daily chores, social, academic, or professional activities
8. The individual has made repeated unsuccessful efforts to control, cut back, or stop daydreaming

B. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning

C. The disturbance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., dementia) and is not better explained by:

• Autism spectrum disorders
• Attention-deficit/hyperactivity disorder
• Schizophrenia spectrum disorders
• Bipolar I disorder
• Obsessive–compulsive and related disorders
• Dissociative identity disorder
• Substance-related and addictive disorders
• An organic disorder
• A Medical condition

The inclusion of Criterion B is important for maladaptive daydreaming because if a person’s daydreaming habits do not cause them any significant distress or impairment then they would not be considered to be suffering from a mental illness.

Criterion C, in which the clinician rules out any other possible cause for the symptoms being experienced, such as substance use or other conditions, is standard for all disorders included in the DSM-V.

The SCIMD isn't the only way to assess for maladaptive daydreaming. We've built an online Maladaptive Daydreaming Test which is based on the official 16-Point Maladaptive Daydreaming Scale, which you can use for free on our website.

How is the SCIMD Scored?

To determine if the interviewee is suffering from MD, the interviewer determines if they are experiencing the following minimum criteria:

• Criterion A
• Criterion A1
• One or more additional criteria from A2 to A8
• Criterion B
• Criterion C

The Structured Clinical Interview can also be used to assess the severity of maladaptive daydreaming based on the level of distress and impairment the patient reports while discussing Criterion B. Based on their answers, three levels of severity can be diagnosed:

• Mild: if the patient experiences distress caused by their condition, but no major impairment to their ability to function
• Moderate: if one important area of life, such as work, education, or social relationships, is impaired by the condition
• Severe: if more than one area of life is affected.

In Summary

Compared to the self-report scale for MD (the MDS-16), the SCIMD has the advantage of being able to assess the severity of the condition as well as simply diagnosing it.

However, like all clinical interviews, it requires a trained clinician to properly conduct the assessment, making it harder to administer.

This doesn’t, however, disqualify the SCIMD as a valid diagnostic method. Rather, it’s just another useful tool that has a time and place in the ongoing diagnosis and treatment of MD.