Continuing the Conversation on Demand Avoidance
In my previous post, I discussed the basics of Pathological Demand Avoidance (PDA).
Pathological Demand Avoidance (PDA) is a relatively new term for service providers in the United States. PDA is a behavioral profile often manifesting as a strong resistance to everyday demands and expectations.
Before we go any further, let's take a moment to better understand Demand Avoidance versus Pathological Demand Avoidance (PDA) (also known as Extreme Demand Avoidance and Pervasive Drive for Autonomy).
Everyone experiences demand avoidance from time to time. Individuals may express demand avoidance by making excuses to avoid tasks, procrastinating on requests, changing the subject to distract from a demand, feigning illness to get out of something, strategically withdrawing from conversations when pressure is applied, or using passive-aggressive tactics to resist expectations; essentially, finding ways to sidestep requests or obligations that feel uncomfortable or overwhelming, even if they are not consciously trying to be defiant. These behaviors are usually not expressed through heightened, reactive emotions that may cause a disruption at home, at work, or in social life.
Pathological Demand Avoidance (PDA) often appears illogical or counter-productive, causing significant disruption to everyday functioning. Individuals expressing PDA behaviors may exhibit dramatic reactions to a request or a demand. The avoidance impulse can even stop individuals from doing things they enjoy. PDA is about avoiding the notion of a demand itself rather than avoiding the action. People avoid things that they feel they ought to do through their own personal expectations, not just things that have been asked of them.
Autistic young adults seeking employment have faced difficulties due to a number of factors such as locating & maintaining a job due to anxiety, decreased self-determination, interviewing challenges, access to transition services, lack of understanding in employers, and autism-related behaviors.
Autistic young adults with a PDA profile may face challenges during transition to adulthood, particularly in accessing appropriate support services and achieving successful employment outcomes.
PDA Examples & Scenarios
A few examples of Pathological Demand Avoidance (PDA) behaviors an individual may exhibit include: Constantly resisting or avoiding everyday requests, using manipulative tactics to sidestep tasks, extreme procrastination, sudden mood swings when faced with demands, excessive need for control, difficulty with routine changes, appearing superficially sociable while lacking depth in relationships, and using elaborate excuses to avoid obligations, and/or stemming from an underlying anxiety about feeling controlled by others.
Specific scenarios that might indicate PDA in an adult may include:
Work challenges
Consistently missing deadlines or finding ways to avoid completing assigned tasks, even if they are important.
Frequently changing jobs due to feeling overwhelmed by work expectations or authority figures.
Using elaborate excuses to explain why they cannot meet deadlines or complete tasks.
Social situations
Canceling plans at the last minute, often due to perceived pressure or feeling like they are being "forced" to attend.
Appearing friendly and engaging but withdrawing when asked to commit to specific plans.
Difficulty maintaining friendships due to unpredictable behavior or sudden changes in mood.
Daily life
Refusing to do basic chores or self-care activities like showering or eating unless explicitly reminded multiple times.
Engaging in lengthy negotiations or arguments to avoid doing something they are asked to do.
Becoming highly agitated or emotionally distressed when presented with a direct request, even if it is simple
Coping mechanisms
Using humor or distraction tactics to deflect attention away from demands
Appearing overly agreeable initially but then finding ways to sabotage or undermine plans later on
Engaging in impulsive behavior to avoid focusing on responsibilities
Consistently missing deadlines or finding ways to avoid completing assigned tasks, even if they are important.
Frequently changing jobs due to feeling overwhelmed by work expectations or authority figures.
Using elaborate excuses to explain why they cannot meet deadlines or complete tasks.
Canceling plans at the last minute, often due to perceived pressure or feeling like they are being "forced" to attend.
Appearing friendly and engaging but withdrawing when asked to commit to specific plans.
Difficulty maintaining friendships due to unpredictable behavior or sudden changes in mood.
Refusing to do basic chores or self-care activities like showering or eating unless explicitly reminded multiple times.
Engaging in lengthy negotiations or arguments to avoid doing something they are asked to do.
Becoming highly agitated or emotionally distressed when presented with a direct request, even if it is simple
Using humor or distraction tactics to deflect attention away from demands
Appearing overly agreeable initially but then finding ways to sabotage or undermine plans later on
Engaging in impulsive behavior to avoid focusing on responsibilities
What Does The Research Say?
Now, let’s dive into what current research reveals about this challenging area, and what it means for those who experience it, as well as those who support them.
Understanding the Nuances of PDA
Recent studies highlight that PDA isn't simply about being "defiant" or "non-compliant". It's rooted in anxiety and a need to control situations. Research shows that individuals with PDA often experience:
Pervasive anxiety: This anxiety significantly impacts how they navigate daily life and demands.
Bidirectional social challenges: Interactions with others can be particularly challenging.
Difficulties negotiating life demands: The everyday expectations of life can become overwhelming.
Extreme mood variability: Switching between seeming cooperative and highly resistant quickly.
One study found that individuals with PDA displayed comparable levels of autistic traits and peer problems to those with autism spectrum disorder (ASD). However, their emotional symptoms exceeded both the ASD group and a group with conduct problems and callous-unemotional traits. This underscores the intense emotional experience that underlies demand avoidance.
It's vital to move beyond labeling behaviors and instead try to understand the drivers behind them. What might look like stubbornness is often a response to feeling overwhelmed. One study highlighted the need for trust and safety in creating a supportive environment for those with PDA.
Implications for Transition Services and Beyond
Current research sheds light on areas that may be affected in young autistic adults with a PDA profile:
Transition Services: For young adults on the autism spectrum, those with PDA traits may struggle with the transition to adulthood and independent living. Transition service providers should be aware of PDA, as this will help them support clients with or without a formal diagnosis.
Employment: The ability to learn and use daily functioning skills are key to employment success, and this may be exacerbated by PDA traits. Additionally, autistic individuals may struggle with impression management during interviews, which can further impact employment outcomes. Transition service providers should focus on interventions that address self-determination, impression management, and strategies for effective job interviews.
Assessment Tools: It is useful for providers to have reliable tools to identify PDA traits. For example, the Extreme Demand Avoidance Questionnaire—Adult version (EDA-QA) is a self-report measure that can be used in initial assessments.
Intervention: A need for effective intervention and support strategies. Interventions that support trust and safety are highly individualized and flexible. These interventions should also include assessments and interventions to target underlying anxiety.
Looking Ahead
Current research highlights the need for increased awareness and understanding of demand avoidance. It is important to recognize that:
Behaviors are not random; they are often an attempt to cope with overwhelming situations.
A focus on anxiety can significantly help.
Individualized, flexible support systems are the most effective.
Low demand parenting, education, and work environments assist in gaining the trust and self-determination often lacking in individuals exhibiting PDA behaviors.
Current studies also highlight a need for more research into effective interventions for PDA, and on how PDA impacts life outcomes. This is particularly important during transitions, such as from high school to adulthood and employment.
What are your experiences with demand avoidance? Share your thoughts in the comments below!
My next blog post will highlight a scale that measures PDA traits in children aged 5 to 17 years old. I will also talk about a scale that measures PDA traits in adults.
Pervasive anxiety: This anxiety significantly impacts how they navigate daily life and demands.
Bidirectional social challenges: Interactions with others can be particularly challenging.
Difficulties negotiating life demands: The everyday expectations of life can become overwhelming.
Extreme mood variability: Switching between seeming cooperative and highly resistant quickly.
Transition Services: For young adults on the autism spectrum, those with PDA traits may struggle with the transition to adulthood and independent living. Transition service providers should be aware of PDA, as this will help them support clients with or without a formal diagnosis.
Employment: The ability to learn and use daily functioning skills are key to employment success, and this may be exacerbated by PDA traits. Additionally, autistic individuals may struggle with impression management during interviews, which can further impact employment outcomes. Transition service providers should focus on interventions that address self-determination, impression management, and strategies for effective job interviews.
Assessment Tools: It is useful for providers to have reliable tools to identify PDA traits. For example, the Extreme Demand Avoidance Questionnaire—Adult version (EDA-QA) is a self-report measure that can be used in initial assessments.
Intervention: A need for effective intervention and support strategies. Interventions that support trust and safety are highly individualized and flexible. These interventions should also include assessments and interventions to target underlying anxiety.
Behaviors are not random; they are often an attempt to cope with overwhelming situations.
A focus on anxiety can significantly help.
Individualized, flexible support systems are the most effective.
Low demand parenting, education, and work environments assist in gaining the trust and self-determination often lacking in individuals exhibiting PDA behaviors.
