{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T10:23:45Z","timestamp":1792664625939,"version":"4.5.0"},"reference-count":29,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2013,10,8]],"date-time":"2013-10-08T00:00:00Z","timestamp":1381190400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Autism"],"published-print":{"date-parts":[[2014,7]]},"abstract":"<jats:p>\u2018Pathological Demand Avoidance\u2019 is a term increasingly used by practitioners in the United Kingdom. It was coined to describe a profile of obsessive resistance to everyday demands and requests, with a tendency to resort to \u2018socially manipulative\u2019 behaviour, including outrageous or embarrassing acts. Pathological demand avoidance is thought to share aspects of social impairment with autism spectrum disorders, but autism spectrum disorder\u2013appropriate strategies, such as routine and repetition, are described as unhelpful. Outrageous acts and lack of concern for their effects draw parallels with conduct problems and callous-unemotional traits. However, reward-based techniques, effective with conduct problems and callous-unemotional traits, seem not to work in pathological demand avoidance. Despite increasing interest and controversy over the pathological demand avoidance label, there is only one published study to date. We present the first systematic comparison of the behavioural profile of children receiving the term pathological demand avoidance (N = 25) to children with autism spectrum disorders (N = 39) or conduct problems and callous-unemotional traits (N = 28), using parent-report indices of psychopathology. The pathological demand avoidance group displayed comparable levels of autistic traits and peer problems to the autism spectrum disorders group and anti-social traits approaching those seen in the conduct problems and callous-unemotional traits group. Emotional symptoms in pathological demand avoidance exceeded both comparison groups. Findings highlight the extreme behavioural impairment associated with pathological demand avoidance and the need to explore whether behavioural overlap reflects a similar neurocognitive basis to existing groups.<\/jats:p>","DOI":"10.1177\/1362361313481861","type":"journal-article","created":{"date-parts":[[2013,10,8]],"date-time":"2013-10-08T22:35:56Z","timestamp":1381271756000},"page":"538-544","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":42,"title":["Pathological demand avoidance: Exploring the behavioural profile"],"prefix":"10.1177","volume":"18","author":[{"given":"Elizabeth","family":"O\u2019Nions","sequence":"first","affiliation":[{"name":"King\u2019s College London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Essi","family":"Viding","sequence":"additional","affiliation":[{"name":"King\u2019s College London, UK"},{"name":"University College London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corina U","family":"Greven","sequence":"additional","affiliation":[{"name":"King\u2019s College London, UK"},{"name":"Radboud University Nijmegen Medical Centre, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelica","family":"Ronald","sequence":"additional","affiliation":[{"name":"Birkbeck, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Happ\u00e9","sequence":"additional","affiliation":[{"name":"King\u2019s College London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2013,10,8]]},"reference":[{"key":"bibr1-1362361313481861","volume-title":"Diagnostic and Statistical Manual of Mental Disorders (DSM-III)","author":"American Psychiatric Association","year":"1980","edition":"3"},{"key":"bibr2-1362361313481861","volume-title":"Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR)","author":"American Psychiatric Association","year":"2000","edition":"4"},{"key":"bibr3-1362361313481861","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890425596"},{"key":"bibr4-1362361313481861","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-7610.2004.00398.x"},{"key":"bibr5-1362361313481861","doi-asserted-by":"publisher","DOI":"10.1001\/jama.289.1.87"},{"key":"bibr6-1362361313481861","volume-title":"Antisocial Process Screening Device","author":"Frick PJ","year":"2001"},{"key":"bibr7-1362361313481861","unstructured":"Frick PJ, Moffitt TE (2010) A proposal to the DSM-V Childhood Disorders and the ADHD and Disruptive Behavior Disorders Work Groups to include a specifier to the Diagnosis of Conduct Disorder based on the presence of Callous -unemotional Traits. 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