Persons with attention-deficit/hyperactivity disorder (ADHD) frequently have a symptom called excessive spontaneous mind wandering even though this is not specifically listed as a diagnostic criterion for ADHD in DSM-5.
What is excessive spontaneous mind wandering?
Persons with ADHD often report that their mind is “always going” or that their mind “constantly full of thoughts.” They may say that several thoughts occur a the same time or that their thoughts don’t last long and instead jump from one thing to another (Mowlen et al., 2016).
So, excessive spontaneous mind wandering has four key characteristics (Bozhilova et al., 2018), which we can remember as occurring in two pairs: quantity and quality.
Quantity:
1. Constantly occurring thoughts
2. Multiple thoughts at the same time
Quality:
1. Changing of the topic of the thoughts, i.e., the thoughts are not focused on just one theme as might occur in a person who is depressed or anxious
2. Changing of the content of the thoughts, i.e., these are not repetitive thoughts like in OCD
Please notice that excessive spontaneous mind wandering leads to inattention (see below) but is not the same as inattention. Also, I have used inserted the word “spontaneous” into the term excessive mind wandering because another type of mind wandering, “deliberate” mind wandering, is not different between people with or without ADHD.
Why is excessive spontaneous mind wandering important?
1. It correlates
2. It is related to impairments in persons with ADHD more than symptoms of inattention,
Why is this? Well, excessive mind wandering leads to
Versus “normal” mind wandering
We all have mind wandering or the occurrence of unrelated thoughts at times. But in persons with ADHD, the frequency, severity, and persistence of mind wandering often lead to considerable impairment in functioning. That is why it is a good idea to use the adjective “excessive” before the term mind wandering.
Versus mind wandering in other disorders
,Mind wandering also occurs in other mental disorders including obsessive-compulsive disorder and mood disorders. But, in ADHD, the thoughts during mind wandering don’t last for long, show a repetitive pattern, or have abnormal content (Kooij et al., 2018).
Mind Excessively Wandering Scale (MEWS)
This is a 15-item self-report scale that assesses the symptoms of mind-wandering (Mowlen et al., 2016).
Related Pages
How to screen all your patients for Adult ADHD
Why don’t we screen every patient for adult ADHD?
References
Bozhilova NS, Michelini G, Kuntsi J, Asherson P. Mind wandering perspective on attention-deficit/hyperactivity disorder. Neurosci Biobehav Rev. 2018 Sep;92:464-476. Review. PubMed PMID: 30036553.
Helfer B, Cooper RE, Bozhilova N, Maltezos S, Kuntsi J, Asherson P. The effects of emotional lability, mind wandering and sleep quality on ADHD symptom severity in adults with ADHD. Eur Psychiatry. 2019 Jan;55:45-51. PubMed PMID: 30384113.
Kooij JJS, Bijlenga D, Salerno L, Jaeschke R, Bitter I, Balázs J, Thome J, Dom G, Kasper S, Nunes Filipe C, Stes S, Mohr P, Leppämäki S, Casas Brugué M, Bobes J, Mccarthy JM, Richarte V, Kjems Philipsen A, Pehlivanidis A, Niemela A, Styr B, Semerci B, Bolea-Alamanac B, Edvinsson D, Baeyens D, Wynchank D, Sobanski E, Philipsen A, McNicholas F, Caci H, Mihailescu I, Manor I, Dobrescu I, Saito T, Krause J, Fayyad J, Ramos-Quiroga JA, Foeken K, Rad F, Adamou M, Ohlmeier M, Fitzgerald M, Gill M, Lensing M, Motavalli Mukaddes N, Brudkiewicz P, Gustafsson P, Tani P, Oswald P, Carpentier PJ, De Rossi P, Delorme R, Markovska Simoska S, Pallanti S, Young S, Bejerot S, Lehtonen T, Kustow J, Müller-Sedgwick U, Hirvikoski T, Pironti V, Ginsberg Y, Félegyházy Z, Garcia-Portilla MP, Asherson P. Updated European Consensus Statement on diagnosis and treatment of adult ADHD. Eur Psychiatry. 2018 Nov 16;56:14-34. PubMed PMID: 30453134.
Mowlem FD, Skirrow C, Reid P, Maltezos S,
Seli P, Smallwood J, Cheyne JA, Smilek D. On the relation of mind wandering and ADHD symptomatology. Psychon Bull Rev. 2015 Jun;22(3):629-36. PubMed PMID: 25561417.
Copyright 2019, Rajnish Mago, MD. All rights reserved. May not be reproduced in any form without express written permission.
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