Pathological demand avoidance
Encyclopedia
Pathological demand avoidance (PDA) is a syndrome
Syndrome
In medicine and psychology, a syndrome is the association of several clinically recognizable features, signs , symptoms , phenomena or characteristics that often occur together, so that the presence of one or more features alerts the physician to the possible presence of the others...

 proposed by Elizabeth Newson to be a specific pervasive developmental disorder
Pervasive developmental disorder
Pervasive developmental disorders is a diagnostic category refers to a group of disorders characterized by delays or impairments in communication, social behaviors, and cognitive development.Pervasive developmental disorders include Autism, Asperger's syndrome, Rett's syndrome, Childhood...

 (PDD) and part of the PDD "family" which also includes autism
Autism
Autism is a disorder of neural development characterized by impaired social interaction and communication, and by restricted and repetitive behavior. These signs all begin before a child is three years old. Autism affects information processing in the brain by altering how nerve cells and their...

.

PDA is not part of the manual of mental disorders DSM-IV, nor is it part of the proposed revision of this manual, the DSM-V. At present, there are no neuroimage, genetic and neurobiological hypotheses for PDA.

Diagnostic criteria

In contrast to most individuals with autism spectrum
Autism spectrum
The term "autism spectrum" is often used to describe disorders that are currently classified as pervasive developmental disorders. Pervasive developmental disorders include autism, Asperger syndrome, Childhood disintegrative disorder, Rett syndrome and Pervasive Developmental Disorder Not Otherwise...

 disorders, individuals with PDA possess superficial social skills and seem to have a theory of mind
Theory of mind
Theory of mind is the ability to attribute mental states—beliefs, intents, desires, pretending, knowledge, etc.—to oneself and others and to understand that others have beliefs, desires and intentions that are different from one's own...

. They often engage in manipulative
Psychological manipulation
Psychological manipulation is a type of social influence that aims to change the perception or behavior of others through underhanded, deceptive, or even abusive tactics. By advancing the interests of the manipulator, often at the other's expense, such methods could be considered exploitative,...

, domineering behavior. The defining criteria are:
  1. Passive early history in the first year, resisting ordinary demands and missing milestones
  2. Continuing to resist demands, resorting to tantrums, distraction techniques
  3. Surface sociability, but apparent lack of sense of social identity
    Social identity
    A social identity is the portion of an individual's self-concept derived from perceived membership in a relevant social group. As originally formulated by Henri Tajfel and John Turner in the 1970s and 80s, social identity theory introduced the concept of a social identity as a way in which to...

    , pride or shame
    Shame
    Shame is, variously, an affect, emotion, cognition, state, or condition. The roots of the word shame are thought to derive from an older word meaning to cover; as such, covering oneself, literally or figuratively, is a natural expression of shame....

  4. Lability of mood and impulsivity
  5. Comfortable in role play and pretending
  6. Language delay
    Language delay
    Language delay is a failure to develop language abilities on the usual developmental timetable. Language delay is distinct from speech delay, in which the speech mechanism itself is the focus of delay...

    , seemingly the result of passivity
  7. Obsessive behavior
  8. Neurological signs (awkwardness, similar to autism spectrum
    Autism spectrum
    The term "autism spectrum" is often used to describe disorders that are currently classified as pervasive developmental disorders. Pervasive developmental disorders include autism, Asperger syndrome, Childhood disintegrative disorder, Rett syndrome and Pervasive Developmental Disorder Not Otherwise...

    disorders)
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