This commentary by Christopher Gillberg provides a historical perspective on Pathological Demand Avoidance (PDA) and its classification. Drawing from 40 years of experience in child and adolescent psychiatry, Gillberg suggests that PDA is not rare and often coexists with conditions like ADHD, anorexia nervosa, and other behavioural syndromes. He acknowledges PDA as a significant clinical issue that requires greater understanding.
The paper praises the development of the Extreme Demand Avoidance Questionnaire (EDA-Q) by Elizabeth O’Nions et al., discussing its usefulness and the need for further research. Gillberg proposes renaming PDA to Extreme Demand Avoidance (EDA) to avoid confusion with “Public Displays of Affection” and to emphasize the undeniable severity of the avoidance. He argues that while the demand avoidance is extreme, debates will continue about whether it is truly pathological. This article is a thought-provoking read for professionals and parents alike.