Everything you need to know about pathological demand avoidance

Pathological demand avoidance (PDA) refers to a condition that forms part of the autism spectrum. Given that pathological demand avoidance (PDA) is not yet formally recognized as a separate diagnosis in all countries, it is possible that some individuals are unaware of it. Moreover, PDA may not be well-known outside of the medical and academic circles, even in nations where it is acknowledged. The validity of PDA as a unique subtype of autism is currently being subject to discussion among specialists because it is a relatively new idea that is still being explored and comprehended.

A person with this condition usually has a significant need to resist or avoid demands. Like other individuals on the autism spectrum, these people experiencing PDA condition may feel that they don’t have much control and can have high anxiety levels.

As a result, they may refuse some requests that they feel are too assertive. Sometimes, this is because of how the individual with PDA interprets the instruction or question at hand. This can cause them to avoid activities and tasks that they may have enjoyed, which can be upsetting to someone with PDA. This article explains everything you need to know about pathological demand avoidance.

Understanding pathological demand avoidance

Pathological demand avoidance (PDA) is increasingly becoming recognized as a unique form of autism. Elizabeth Newson, a British psychologist termed this condition which describes anxiety to be in control and avoid people’s demands and expectations.

Demand avoidance which is in the PDA profile appears quite different from what other people experience with the autism profile because it has an extreme and obsessive nature. This extreme avoidance can even extend to the most basic demands involved in everyday living.

This means it doesn’t only relate to the avoidance of difficult, unpleasant, unappealing, or anxiety-provoking tasks and activities. Worse still, some people with the PDA condition may have enormous difficulty doing activities they desire to do or achieving their self-imposed goals.

Keep in mind that PDA can affect both males and females, there is no evidence to show the prevalence rates. Besides, this condition is not caused by how you were raised, your social circumstances, and it’s not your fault or your parent’s fault. Unfortunately, PDA is usually misdiagnosed because it appears on the surface like other conditions, such as the conduct disorder, attention deficit hyperactivity disorder, and reactive attachment disorder.

Features related to PDA

When confronted with demands or expectations that they view as frightening or overpowering, people with PDA may suffer from severe anxiety and distress. These people also have a strong need to be in control of their environment. As a result, they could object to tasks and instructions and engage in manipulative activities like making up justifications or negotiating. (1) 

This can make it difficult for those who work with people with PDAs to establish routines and structures, as well as to assist them in finishing activities and living up to expectations. Individuals with PDA may also have trouble keeping to schedules or adhering to plans because they may feel that doing so limits their autonomy and ability to exert control over their environment. (1)

Situations or demands that can cause anxiety, like a change in routine and social situations can trigger PDA. This can also extend to all your daily demands, suggestions, and expectations, including some of the activities that you would normally enjoy doing.

Giving people with PDAs a sense of control and autonomy, breaking down work into manageable pieces, and, when possible, offering options and alternatives are all effective ways to support them. Establishing clear expectations and boundaries but still being adaptable and attentive to the individual’s requirements and preferences may be beneficial. (2)

Here are some of the features associated with someone with the PDA condition:

Avoiding and resisting the ordinary demands of life

When it comes to avoiding and resisting the usual demands of life, they may include joining activities organized by a family, getting up, or even getting dressed. This may sometimes apply when you want to avoid or resist doing activities that have been suggested like watching a movie that everyone has been looking forward to.

Once the initial avoidance strategies are put in place and they fail, the situation may quickly intensify and some people can opt to do more extreme activities just to resist or avoid the demand. These include swearing, shouting, and hitting and damaging property. You can also see others who simply just shut down, run away, or withdraw. If you observe this type of behavior, you should know that it’s a meltdown and can be considered a panic attack.

It’s crucial to remember that avoiding and opposing demands is not just a technique for people with PDA to cope with their anxiety and feelings of being overwhelmed, but also a sort of defiance or disobedience. It’s crucial to understand that avoiding and opposing demands can negatively affect a person’s functioning on a daily basis and make it difficult for them to engage in commonplace activities and social settings.

Social strategies

Many other people with PDA conditions can also use social strategies just to avoid doing tasks. For example, they can compliment you just to distract the demand while others can give excuses, such as I can’t do an activity because my hand is broken. In some cases, they can try to delay doing activities by stating they will do it in five minutes. Another common social strategy is when they withdraw into fantasy like I am a pet and pets don’t wear clothes.

Using praises or other flattery to divert attention from the current activity is a typical tactic. For instance, someone with PDA might compliment someone on their expertise or attractiveness in an effort to draw attention away from the task they are being asked to do. Another tactic is offering excuses or reasons for why they cannot finish a task. Physical causes, like a broken hand, or more general causes, like feeling unwell or being overly exhausted, can fall under this category. They may be hoping to avoid the stress and worry that comes with meeting obligations and expectations by explaining why they are unable to accomplish a task.

It’s important to note that these social strategies are not necessarily malicious or intentional, but rather a way for individuals with PDA to cope with their anxiety and discomfort. Understanding and addressing these strategies can be an essential part of supporting individuals with PDA in meeting their goals and achieving success.

Appearing social

a man in a bun and woman talking

People with PDA can sometimes look sociable on the surface, such as having a more socially acceptable use of their eye contact. They may seem like they have better conversational skills than people on the autism spectrum. However, they behave like this because they may lack depth in understanding.

For example, they may not see any difference between an authority figure and themselves. In most cases, people with PDA may also have difficulties adjusting their behavior to respond to the needs of other people. In other words, they may not understand why, or how their behavior may affect other people emotionally leading to a negative impact on the relationships.

People with PDA may have difficulty understanding the emotional impact of their behavior on others, which can lead to social misunderstandings and conflicts. For example, they may engage in behaviors that others find rude or hurtful without realizing the effect of their actions on others. This may be due to their limited ability to understand the emotional reactions of others, as well as their own difficulty in regulating their own emotions.

Moreover, individuals with PDA may have difficulty adapting to social situations, which can make it challenging for them to respond appropriately to the needs of others. They may struggle to understand why certain behaviors are expected in different social contexts, which can make it difficult for them to modify their own behavior accordingly.

Mood swings

a man in  a black shirt

Individuals with PDA are also known to have impulsive behavior and excessive mood swings. They can have problems controlling their emotions and reactions to people and situations.

They can quickly change from an engaging and happy person to a sad or angry person in just seconds, quite often with no warning or visible build-up to others. This can be in response to the pressure they feel to perceived expectations and demands.

It is important to note that mood swings are not a diagnostic criteria for PDA, but they can be a common feature of the condition. Strategies to help manage emotional dysregulation, such as mindfulness or cognitive-behavioral therapy, may be helpful for individuals with PDA to improve their emotional regulation skills and reduce the frequency or intensity of mood swings.

Roleplay and pretense

It’s quite common to see people with PDA who become comfortable in role play and pretense. This can sometimes get to the extreme to make it hard to see the difference between pretense and reality. For example, they can adopt the persona of someone in authority in role-playing scenes and they reach an extent of believing that they are that individual.

This role can usually require them to direct and oversee other people. As a result, they may decide to remain in control, such as taking on the role of a policeman while playing with peers. They can use this role play as a technique to avoid demands that are made by others like I can’t pick up a toy because I am a car and cars don’t have hands. Some people with PDA can also withdraw into a fantasy world as a way of self-protection. This means it can be a place where they can go to when real-life situations become too hard to cope with and manage.

As you can see, people with PDA can go through various behaviors, but you need to avoid taking it personally. This is because they are simply responding to their anxieties. Hence, you need to find the right resources so that you can handle some challenging situations. This is the best way you can give a better perspective on your child.



(1) https://www.pdasociety.org.uk/what-is-pda-menu/what-is-demand-avoidance/

(2) https://childmind.org/article/pathological-demand-avoidance-in-kids/#:~:text=All%20kids%20avoid%20doing%20things,often%20in%20people%20with%20autism.