Pathological Demand Avoidance Test

What is pathological demand avoidance?

Also known as extreme demand avoidance, pathological demand avoidance (PDA) delves into the intricate behaviors of individuals who go to great lengths to evade or ignore perceived "demands." These "demands" can refer to everyday demands like getting dressed or completing a task, ordinary demands such as following instructions, and even internal demands, like personal expectations or responsibilities. While PDA is not formally recognized as a mental health diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (DSM), it holds significant relevance due to its potential to cause functional impairment and impact an individual's overall quality of life.

PDA was coined by Elizabeth Newson in 2003. The term initially identified individuals with pervasive developmental disorders (PDD) exhibiting distinct traits associated with demand avoidance. However, over time, the understanding of PDD has evolved, and it is now recognized as part of autism spectrum disorder. According to the National Autistic Society, while there is no formally recognized and separate PDA diagnosis, many individuals may be diagnosed with autism and have a "demand avoidant profile" or a "PDA profile" noted in their records. It is not required for an autism diagnosis but may help better understand certain behavioral traits.

Signs of PDA manifest in behaviors that may seem obsessive, coupled with an intense need for control over the environment. One common misconception is misidentifying these behaviors as mere defiance or oppositionality. It is crucial to note that demands are not solely verbal instructions; even subtle gestures or silent offerings can be perceived as demands. This nuanced understanding helps in distinguishing PDA from other behavioral issues.

It's important to remember that PDA is not a one-size-fits-all concept. Its manifestation varies significantly from person to person, emphasizing the importance of individualized approaches to diagnosis and treatment. Recognizing the diversity in how PDA presents itself is crucial in fostering understanding and providing tailored support for affected individuals.

How to use our Pathological Demand Avoidance Test  template

The Extreme Demand Avoidance Questionnaire (EDA-Q) assesses traits associated with PDA. While it's essential to note that the EDA-Q is not an autism assessment or a diagnostic tool, it can provide valuable insights into behaviors indicative of demand avoidance. Here are step-by-step instructions on how to use the EDA-Q assessment:

Step 1: Grab a copy of the questionnaire

In this guide, you may open our PDA autism test template in the Carepatron app by clicking the "Use template" button. Alternatively, you may download a non-customizable PDF copy by clicking "Download."

Step 2: Review

Before starting, review any accompanying information or instructions provided with the questionnaire. Understand the assessment's purpose and the collected data's intended use. Furthermore, ensure the questionnaire is appropriate for the individual/s being assessed.

Step 3: Obtain consent

If you are administering the EDA-Q, ensure that you have obtained informed consent from the individuals or their legal guardians, particularly if they are minors.

Step 4: Conduct the test

Once you've obtained their consent, choose a quiet and comfortable setting for the assessment to minimize distractions and ensure accurate responses. Afterward, clearly explain the purpose of the questionnaire to the individuals participating. Emphasize that there are no right or wrong answers and that the goal is to gather information about specific behaviors.

Depending on the participants' needs, read the questions aloud or provide them with written instructions. Ensure that everyone understands the wording of each question. Give participants sufficient time to consider and respond to each question. This will help ensure thoughtful and accurate answers.

Step 5: Score and analyze

Collect the participant/s' response/s systematically. Ensure that the responses are recorded accurately and attributed to the correct individual. Refer to the scoring guidelines provided with the EDA-Q. Follow the specified instructions for tallying the scores.

Once the scores are tallied, interpret the results by the guidelines provided. Keep in mind that the EDA-Q only provides an indication of traits associated with demand avoidance but does not diagnose PDA.

Step 6: Proceed with the next steps

If the results of the EDA-Q suggest the presence of traits associated with demand avoidance, it is crucial to have the patient consult with other healthcare professionals for a comprehensive evaluation.

Scoring and interpretation

To score the EDA-Q, tally the responses according to the instructions provided. Scores for most questions range from 0 (Not true) to 3 (Very true), except for questions 14 and 20, which are reverse scored. The total score helps identify if the individual exhibits marked demand avoidance behaviors. However, this is not an autism assessment and should not be used to definitively diagnose PDA behaviors or pervasive developmental disorder. Consulting with a professional is necessary for a complete evaluation.

Recommended next steps

After completing the Extreme Demand Avoidance Questionnaire for Adults, understanding the next steps is crucial for individuals seeking further insights into potential PDA traits.

Consult a specialist

If you are not a specialist in ASD, seek the guidance of a healthcare professional who specializes in autism spectrum disorder, especially if you suspect your patient might have traits associated with PDA. While the EDA-Q provides valuable insights, only a specialist can provide a formal diagnosis and recommend appropriate coping strategies.

Engage with education professionals

Children or adolescents exhibiting PDA behaviors may benefit from working with education professionals who understand and accommodate their unique needs. Collaboration with educators ensures that the child receives appropriate support in school settings, where demands are often frequent and unavoidable.

Contact the PDA Society

The PDA Society offers resources, information, and support for individuals, families, and professionals dealing with PDA. Connecting with the PDA Society can provide guidance on managing behaviors, understanding demand avoidance, and accessing additional resources or support networks.

Remember, these are general guidelines, and the specific next steps can vary depending on individual circumstances. Additionally, other healthcare professionals may employ various assessments and diagnostic tools to evaluate potential neurodevelopmental conditions comprehensively.