Welcome to Fox Fern ADHD Clinic's guide to Pervasive Drive for Autonomy, also known as Extreme Demand Avoidance (EDA) or Pathological Demand Avoidance (PDA).
Pathological Demand Avoidance (PDA) is a term that traces its origins back to the 1980s. It was first coined by Professor Elizabeth Newson to describe the behavioral profile of a specific group of children she was evaluating.
The term made its debut in scholarly literature in a journal article published in 2003, cementing its place in academic discourse. Newson depicted PDA as a subtype within the broader category of Pervasive Developmental Disorders.
Over time, our understanding of neurodivergent disorders, including ADHD and autism, has evolved. Diagnostic criteria are continually revised and refined to reflect ongoing research and clinical findings. As part of this evolution, PDA has been increasingly, albeit not universally, recognized as a profile that is observed in some individuals with neurodivergence. In other words, not all people on the ADHD or Autism spectrum exhibit PDA, but PDA is considered a part of the spectrum.
The terminology itself has also seen some evolution. As the term Pathological Demand Avoidance has met with some resistance due to the negative connotations associated with the word "pathological," an alternative term, Extreme Demand Avoidance, has gained traction. Many believe the word "extreme" provides a more accurate and less stigmatizing description of the behaviors associated with this condition. Our clinic commonly uses Tomlin Wilding's interpretation termed: ‘Pervasive Drive for Autonomy (PDA)’ because we feel it is a more accurate description of the experience, and it focuses less on demand avoidance and more on the core issue: the drive for autonomy.
Pervasive Drive for Autonomy, or PDA, is a unique behavioral profile related to neurodivergence. It isn't a formal diagnosis in the DSM-5 or ICD-10 and is not well-known in America, though it is widely acknowledged in the United Kingdom. At its core, PDA is an anxiety-driven need for autonomy, leading to avoidance of demands and expectations to remain in control. The drive for autonomy is so intense that even minor demands can trigger extreme reactions.
PDA individuals, or PDAers, may desire to meet these demands but find themselves unable due to overwhelming anxiety. This intense drive for autonomy can lead to frequent meltdowns, school refusal, difficulty transitioning into adulthood, and other challenges.
Several misconceptions surround PDA due to its relatively unknown status and the unique behaviors of PDAers. For instance:
Persistent Need for Autonomy: Individuals with PDA exhibit an intense and enduring need for self-determination and autonomy. This may manifest in several ways, including a strong preference for doing things their own way, resisting tasks imposed by others, and experiencing significant emotional responses (e.g., anger, anxiety, panic) when they perceive their autonomy is threatened. To maintain or regain their autonomy, they might resort to various behaviors like avoidance, procrastination, making jokes, role-play, or even 'controlling' the actions of others.
Inconsistencies in Engaging Tasks: These individuals might appear enthusiastic about an activity initially, only to avoid doing it later on. Standard strategies to encourage their participation, such as praise, guidance, or rewards, may not be effective. However, they tend to engage more effectively in tasks or situations where they can actively participate in decision-making or where the context aligns with their interests.