Resources

Pathological demand avoidance in children and adolescents: A systematic review

There has been a lack of funding of research into PDA to date and so this timely paper is particularly useful for giving an overview of the research history and looking to the future and what is needed.

With any newly identified entity, construct or concept there is a period of time where knowledge is necessarily limited, and a variety of investigations will be needed to judge in what ways, if any, it is helpful. It isn’t a reflection on the work done to date, but a feature of research development that means that there is more to do.

It is unfortunate that this review was conducted before the publication of more authoritative clinically-based research (such as Eaton and Weaver). Nevertheless, they point to a number of areas where research is still much needed. The paper highlights the particular value in longitudinal studies which might look at avoidant behaviour over time. Detailed research into the nature of ‘demands’, and the impact of context and environment upon them is another important starting point. They also suggest the need for systematic explorations of associations between PDA and anxiety and traumatic experiences.

If the notion of PDA is to be used in the years to come, it is essential to demonstrate that it is something that is helpful for outcomes (both short and long-term). The questions highlighted by the paper demonstrate the need for more research, not less.

Authors: Kildahl, Helverschou, Rysstad, Wigaard, Hellerud, Ludvigsen and Howlin