Abstract
Research into Pathological Demand Avoidance (PDA), which has been suggested to be a subgroup within the Autism Spectrum Disorder (ASD), is almost nonexistent in spite of the frequent reference to the condition in clinical practice. The total population of 15 to 24-year-olds in the Faroe Islands was screened for ASD, and 67 individuals were identified who met diagnostic criteria for ASD (corresponding to a general population prevalence of ASD of almost 1 %). Of these 67, 50 had parents who were interviewed using the Diagnostic Interview for Social and Communication Disorders (DISCO-11) which contains 15 “PDA-specific” items. Nine individuals met criteria for “possible clinical diagnosis of PDA”, meaning that almost one in five of all with ASD also had indications of having had PDA in childhood, and that 0.18 % of the total population had had the combination of ASD and PDA. However, at the time of assessment, only one of the 9 individuals with possible PDA still met “full criteria”. PDA possibly constitutes a considerable minority of all cases with ASD diagnosed in childhood, but criteria for the condition are unlikely to be still met in later adolescence and early adult life.
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Ellefsen A, Kampmann H, Billstedt E, Gillberg IC, Gillberg C (2007) Autism in the Faroe Islands. An epidemiological study. J Autism Dev Disord 37:437–444
Ehlers S, Gillberg C, Wing L (1999) A screening questionnaire for asperger syndrome and other high-functioning autism spectrum disorders in school age children. J Autism Dev Disord 29:129–141
Gillberg C (2010) The ESSENCE in child psychiatry: early symptomatic syndromes eliciting neurodevelopmental clinical examinations. Res Dev Disabil 31:1543–1551. doi:10.1016/j.ridd.2010.06.002
Gillberg C (2014) PDA—Public display of affection or pathological demand avoidance?—reflections on O´Nions et al. (2014). J Child Psychol Psychiatry 55(7):769–770. doi:10.1111/jcpp.12275
Newson E, Le Maréchal K, David C (2003) Pathological demand avoidance syndrome: a necessary distinction within the pervasive developmental disorders. Arch Dis Child 88:595–600 (Review)
Kocovska E, Biskupsto R, Gillberg IC, Ellefsen A, Kampmann H, Vang S et al (2012) The rising prevalence of autism: a prospective longitudinal study in the Faroe Islands. J Autism Dev Disord 42:1959–1966. doi:10.1007/s10803-012-1444-9
Kopp S, Gillberg C (1997) Selective mutism: a population-based study: a research note. J Child Psychol Psychiatry 38:257–262
Lord C, Rutter M, LeCouteur A (1994) Autism diagnostic interview- revised: a revised version of a diagnostic interview for caregivers of individuals with possible pervasive developmental disorders. J Autism Dev Disord 24:659–685
O´Nions E, Viding E, Greven CU, Ronald A, Happé F (2013) Pathological demand avoidance: exploring the behavioural profile. Autism 18:538–544 (Epub ahead of print)
O´Nions E, Christie P, Gould J, Viding E, Happé F (2013) Development of the ‛Extreme Demand Avoidance Questionnaire’ (EDA-Q): preliminary observations on a trait measure for pathological demand avoidance. J Child Psychol Psychiatry 55:758–768. doi:10.1111/jcpp.12149 (Epub 2013 Oct 7)
Reilly C, Atkinson P, Happé F, O´Nions E, Neville B, Gillberg C (2014) Extreme demand avoidance in childhood epilepsy: four case studies. Res Dev Disabil 35:3236–3244. doi:10.1016/j.ridd.2014.08.005
Rogers J, Viding E, Blair J, Frith U, Happé F (2006) Autism spectrum disorders and psychopathy: shared cognitive underpinnings or a double hit? Psychol Med 36:1789–1798
Wechsler D (1992) Wechsler intelligence scale for children-third edition. Psychological Corporation, London
Wechsler D (1981) Wechsler adult intelligence scale-revised. Psychological Corporation, San Antonio
Wing L, Gould J (1978) Systematic recording of behaviors and skills of retarded and psychotic children. J Autism Child Schizophr 8:79–97
Wing L, Leekam SR, Libby SJ, Gould J, Larcombe M (2002) The diagnostic interview for social and communication disorders: background, inter-rater reliability and clinical use. J Child Psychol Psychiatry 43:307–325
Wing L (2006) Diagnostic interview for social and communication disorders, 11th edn. Centre for Social and Communication Disorders, Bromley
Wing L, Gould J, Gillberg C (2011) Autism spectrum disorders in the DSM-V: better or worse than the DSM-IV?. Res Dev Disabil 32:733–768. doi:10.1016/j.ridd.2010.11.003
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The study is funded by the Swedish Research Council.
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None of the five authors have a conflict of interest to declare.
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Gillberg, C., Gillberg, I.C., Thompson, L. et al. Extreme (“pathological”) demand avoidance in autism: a general population study in the Faroe Islands. Eur Child Adolesc Psychiatry 24, 979–984 (2015). https://doi.org/10.1007/s00787-014-0647-3
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DOI: https://doi.org/10.1007/s00787-014-0647-3