{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T14:40:44Z","timestamp":1792852844879,"version":"4.5.0"},"reference-count":10,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2013,10,7]],"date-time":"2013-10-07T00:00:00Z","timestamp":1381104000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000269","name":"ESRC","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100000269","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Child Psychology Psychiatry"],"published-print":{"date-parts":[[2014,7]]},"abstract":"\n Background<\/jats:title>\n \n Pathological Demand Avoidance (\n PDA<\/jats:styled-content>\n ) is a term increasingly used in the\n United Kingdom<\/jats:styled-content>\n to describe children who obsessively resist everyday demands, going to extreme lengths to avoid these. There is debate about its relationship with both autism spectrum disorder (\n ASD<\/jats:styled-content>\n ) and oppositional defiant disorder (\n ODD<\/jats:styled-content>\n ). Unlike\n ASD<\/jats:styled-content>\n , children with\n PDA<\/jats:styled-content>\n are said to use socially manipulative avoidance strategies; and unlike\n ODD<\/jats:styled-content>\n , they resort to extreme, embarrassing or age\u2010inappropriate behaviour. To date, there has been little research into\n PDA<\/jats:styled-content>\n , and it remains contentious. Currently, there are no questionnaire instruments available to aid consistency in description. This study reports the development and preliminary validation of the \u2018Extreme Demand Avoidance Questionnaire\u2019 (\n EDA<\/jats:styled-content>\n \u2010Q), designed to quantify\n PDA<\/jats:styled-content>\n traits based on parent\u2010reported information.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n The validation study involved data from 326 parents of children aged 5\u201017 allocated to six groups based on information reported by parents about received diagnoses and behavioural difficulties: (a) typically developing children (\n N<\/jats:italic>\n \u00a0=\u00a0102), (b) children with\n ASD<\/jats:styled-content>\n without<\/jats:italic>\n disruptive behaviour (\n N<\/jats:italic>\n \u00a0=\u00a036), (c) children with\n ASD<\/jats:styled-content>\n with<\/jats:italic>\n disruptive behaviour (\n N<\/jats:italic>\n \u00a0=\u00a048), (d) children for whom\n PDA<\/jats:styled-content>\n was suspected by parents (irrespective of other diagnoses) (\n N<\/jats:italic>\n \u00a0=\u00a067), (e) children who had, according to parents, been identified as having\n PDA<\/jats:styled-content>\n by a health professional, irrespective of other diagnoses (\n N<\/jats:italic>\n \u00a0=\u00a050), and (6) disruptive behaviour or behavioural problems without suspected\/identified\n ASD<\/jats:styled-content>\n or\n PDA<\/jats:styled-content>\n (\n N<\/jats:italic>\n \u00a0=\u00a023).\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Although the Strengths and Difficulties Questionnaire (\n SDQ<\/jats:styled-content>\n ) did not differentiate\n PDA<\/jats:styled-content>\n from those with\n ASD<\/jats:styled-content>\n plus disruptive behaviour; score on the\n EDA<\/jats:styled-content>\n \u2010Q was significantly higher in\n PDA<\/jats:styled-content>\n than all comparison groups.\n ROC<\/jats:styled-content>\n analysis indicated good sensitivity (.80) and specificity (.85). Across all case groups, females scored higher than males on the\n EDA<\/jats:styled-content>\n \u2010Q. Separate cut\u2010off scores were identified for older and younger age\u2010groups.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Our findings highlight the potential utility of the\n EDA<\/jats:styled-content>\n \u2010Q to assist the identification of this unusual profile for future research.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/jcpp.12149","type":"journal-article","created":{"date-parts":[[2013,10,11]],"date-time":"2013-10-11T21:59:01Z","timestamp":1381528741000},"page":"758-768","source":"Crossref","is-referenced-by-count":51,"title":["Development of the \u2018Extreme Demand Avoidance Questionnaire\u2019 (\n EDA<\/scp>\n \u2010Q): preliminary observations on a trait measure for Pathological Demand Avoidance"],"prefix":"10.1111","volume":"55","author":[{"given":"Elizabeth","family":"O'Nions","sequence":"first","affiliation":[{"name":"MRC Social, Genetic and Developmental Psychiatry Centre Institute of Psychiatry King's College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phil","family":"Christie","sequence":"additional","affiliation":[{"name":"The Elizabeth Newson Centre Sutherland House Children's Services (NORSACA) Nottinghamshire UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith","family":"Gould","sequence":"additional","affiliation":[{"name":"The NAS Lorna Wing Centre for Autism Bromley Kent UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Essi","family":"Viding","sequence":"additional","affiliation":[{"name":"Developmental Risk & Resilience Unit Division of Psychology and Language Sciences Clinical, Educational, and Health Psychology Research Department University College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Happ\u00e9","sequence":"additional","affiliation":[{"name":"MRC Social, Genetic and Developmental Psychiatry Centre Institute of Psychiatry King's College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,10,7]]},"reference":[{"key":"e_1_2_8_2_1","first-page":"3","article-title":"The distinctive clinical and educational needs of children with pathological demand avoidance syndrome: Guidelines for good practice","volume":"8","author":"Christie P.","year":"2007","journal-title":"Good Autism Practice (GAP)"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1023\/A:1021803005547"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-7610.1997.tb01545.x"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/00004583-200111000-00015"},{"key":"e_1_2_8_6_1","first-page":"34","article-title":"Missed diagnosis or misdiagnosis? Girls and women on the autism spectrum","volume":"12","author":"Gould J.","year":"2011","journal-title":"Good Autism Practice (GAP)"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ridd.2011.05.017"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.88.7.595"},{"key":"e_1_2_8_9_1","article-title":"Pathological Demand Avoidance (PDA): Exploring the behavioural profile","author":"O'Nions E.","journal-title":"Autism: The International Journal of Research and Practice"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1258\/jrsm.2011.110223"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/1469-7610.00023"}],"container-title":["Journal of Child Psychology and Psychiatry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fjcpp.12149","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fjcpp.12149","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acamh.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jcpp.12149","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T19:37:45Z","timestamp":1762198665000},"score":1,"resource":{"primary":{"URL":"https:\/\/acamh.onlinelibrary.wiley.com\/doi\/10.1111\/jcpp.12149"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,10,7]]},"references-count":10,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2014,7]]}},"alternative-id":["10.1111\/jcpp.12149"],"URL":"https:\/\/doi.org\/10.1111\/jcpp.12149","archive":["Portico"],"relation":{},"ISSN":["0021-9630","1469-7610"],"issn-type":[{"value":"0021-9630","type":"print"},{"value":"1469-7610","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,10,7]]}}}