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Extreme (“pathological”) demand avoidance in autism: a general population study in the Faroe Islands

A study was carried out to determine the frequency of Pathological Demand Avoidance (PDA) within a group of individuals identified as having met the diagnostic criteria for Autism Spectrum Disorder (ASD). This is a thought-provoking read for professionals and those interested in the diagnostic criteria for PDA.

The entire population of 15 to 24 year olds living in the Faroe Islands were screened for ASD; 67 individuals met the diagnostic criteria. The parents of 50 of these individuals had been interviewed using the Diagnostic Interview for Social and Communication Disorders (DISCO). This tool contains 15 ‘PDA specific’ items. Nine individuals met criteria for ‘a possible clinical diagnosis of PDA’ meaning one in five of those with ASD had indications of having PDA in childhood. At the time of assessment only one individual with possible PDA still met the ‘full criteria’.

The study found that PDA possibly constitutes a minority of all cases of ASD diagnosed in childhood but criteria for the condition are unlikely to be still met in later adolescence and early adult life.

Authors:  Christopher Gillberg, Carina Gillberg, Lucy Thompson, Rannvá Biskupsto and Eva Billstedt

First published:  European Child & Adolescent Psychiatry, August 2015, Volume 24, Issue 8, pp 979–984