The association between maladaptive daydreaming and eating and obsessive-compulsive disorders in the general population: the mediating role of alexithymia

Maladaptive daydreaming (MD) is a recently defined clinical condition characterized by an excessively immersive utilization of fantasy and imagination which can significantly impact both professional and social life. International literature has linked MD to obsessive-compulsive symptoms, but its association with alexithymia remains largely unexplored, and its connection to eating disorder symptoms is even more neglected. As a marker of affect regulation difficulties, alexithymia may heighten the risk and severity of MD, eating disorders, and obsessive-compulsive symptoms. Therefore, the general aim of the present study is to contribute to the study of MD in the general population, by examining potential associations between MD levels, eating disorders, obsessive-compulsive symptoms, and affect regulation capabilities. Additionally, the study aims to examine whether alexithymia mediates the relationship between eating and obsessive-compulsive symptoms, respectively, and MD levels. 562 participants (mean age = 27.16 years; SD = 10.21; 68% females) completed an online survey comprising: a socio-demographic questionnaire, the Maladaptive Daydreaming Scale (MDS), the 20-item Toronto Alexithymia Scale (TAS-20), the Eating Attitude Test (EAT-26), and the Obsessional Beliefs Questionnaire (OBQ-44). MDS score was positively related to TAS-20 total, difficulties in identifying and describing feelings as well as with eating disorders and obsessive-compulsive symptoms. Age showed a weak negative association with MDS. Regarding the mediation models, alexithymia significantly amplified the impact of eating/obsessive-compulsive symptoms on MD. The associations emerging by present study seem to support a common functioning of these clinical conditions based on maladaptive/compulsive behaviours/thought/fantasy, as strategy to regulate painful emotions. Further studies comparing these clinical populations are still needed.