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  • Pathological demand avoidance in children and adolescents: A systematic review

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    Author(s)
    Kildahl, Arvid N
    Helverschou, Sissel B
    Rysstad, Anne L
    Wigaard, Elisabeth
    Hellerud, Jane Ma
    Ludvigsen, Linn B
    Howlin, Patricia
    Griffith University Author(s)
    Howlin, Patricia
    Year published
    2021
    Metadata
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    Abstract
    LAY ABSTRACT: Requests for diagnoses of pathological demand avoidance have increased over recent years, but pathological demand avoidance remains a controversial issue. The concept of pathological demand avoidance has been criticised for undermining the self-advocacy of autistic people and neglecting the potential role of anxiety as a possible underlying or contributing cause. The current study was undertaken to summarise and review the methodological quality and findings from current research into pathological demand avoidance in children and adolescents. Further aims were to describe how pathological demand avoidance has ...
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    LAY ABSTRACT: Requests for diagnoses of pathological demand avoidance have increased over recent years, but pathological demand avoidance remains a controversial issue. The concept of pathological demand avoidance has been criticised for undermining the self-advocacy of autistic people and neglecting the potential role of anxiety as a possible underlying or contributing cause. The current study was undertaken to summarise and review the methodological quality and findings from current research into pathological demand avoidance in children and adolescents. Further aims were to describe how pathological demand avoidance has been identified and to explore the relationships with autism and other developmental and psychiatric disorders. After a comprehensive search, 13 relevant studies using a wide range of methods were identified and systematic quality assessments were undertaken. All the studies had based the identification of pathological demand avoidance, directly or indirectly, on descriptions from the original study by Newson and colleagues. However, the methods used to develop these criteria were not clearly described. Most studies relied exclusively on parental report for data, and there was a general failure to take account of alternative explanations for the behaviours under study. No studies explored the views of individuals with pathological demand avoidance themselves. Problems concerning definition and measurement in the reviewed studies currently limit any conclusions regarding the uniformity or stability of the behaviours described, or the characteristics of individuals displaying them. Relationships between pathological demand avoidance and other emotional and behavioural difficulties should be explored in future research, as should the perspectives of individuals with pathological demand avoidance themselves.
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    Journal Title
    Autism
    DOI
    https://doi.org/10.1177/13623613211034382
    Copyright Statement
    © The Author(s) 2021. This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
    Subject
    Specialist studies in education
    Psychology
    Cognitive and computational psychology
    anxiety
    autism
    pathological demand avoidance
    Publication URI
    http://hdl.handle.net/10072/406678
    Collection
    • Journal articles

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