Pathological demand avoidance

Pathological demand avoidance
Other names	Persistent drive (for) autonomy, extreme demand avoidance, demand avoidance, demand avoidance phenomenon, rational demand avoidance
Specialty	Psychiatry
Symptoms	Task avoidance, anxiety, need to control, social manipulation, masking, emotional lability, intolerance of uncertainty

Pathological demand avoidance (PDA), or extreme demand avoidance (EDA), or persistent drive (for) autonomy (PDA) is a behavioral profile characterized by an intense resistance to complying with requests or expectations and extreme efforts to avoid social demands. As it is not recognized as an independent syndrome, PDA is not included in criteria or diagnoses listed in the International Classification of Diseases (ICD-11) or the Diagnostic and Statistical Manual of Mental Disorders. PDA is thought to involve a highly sensitive nervous system in which perceived threats—particularly demands or limits on autonomy—can trigger fight, flight, or freeze responses, even when those threats are not obvious to others. It is suggested that any expectation or activity, such as brushing teeth or getting ready to leave home to visit a playground, can trigger avoidant behavior. If the demand cannot be avoided, a panic attack or a meltdown may ensue.