Reflections on 2014 paper by O’Nions et al


Commentary: PDA – public display of affection or pathological demand avoidance? – reflections on O'Nions et al. (2014)

This commentary piece contains a succinct summary of the history of Pathological Demand Avoidance (PDA). It is an interesting read for professionals and parents as it raises points for discussion regarding the incidence, nomenclature and classification of PDA.

The author draws on his 40 years of experience as a professor of child and adolescent psychiatry to suggest that PDA presents along with a multitude of disorders including ADHD, anorexia nervosa and certain behavioural phenotype syndromes. He argues it ‘is not an extremely rare phenomenon’ and recognises that ‘PDA is already a very real clinical problem’.

Recognition and praise is given to the development of the EDA-Q by Elizabeth O’Nions et al. Its use and value is discussed and the need for further research highlighted.

The author suggests PDA is renamed ‘Extreme Demand Avoidance’ (EDA) to avoid confusion with ‘Public Displays of Affection’ and ‘because there can be no argument that the demand avoidance is extreme, but there will always be those who will have problems determining if the avoidance is pathological or not’.


Author:  Christopher Gillberg

First published:  Journal of Child Psychology and Psychiatry, 3rd June 2014