Examining the relationship between anxiety and pathological demand avoidance in adults: a mixed methods approach

This mixed‑methods study investigated how anxiety and intolerance of uncertainty (IU) are linked to Pathological Demand Avoidance (PDA) in adults. In Experiment 1, an online survey of 163 adults found that both general anxiety (measured by MASQ‑D30) and IU (via IUS‑12) were significant predictors of PDA traits (via the EDA‑QA). In Experiment 2, follow‑up interviews with 13 participants revealed four key themes shaping demand‑avoidant behaviour: the dynamic between approach and avoidance, factors biasing anticipation of demands, underlying vulnerabilities, and developmental patterns. Collectively, the findings suggest that anxiety and IU continue to underpin and maintain PDA-like behaviours in adults, with anticipatory responses playing a critical role in triggering avoidance.