December 1, 2020
Category:

The EDA-QA

Last updated on August 19, 2022

The Extreme Demand Avoidance Questionnaire for Adults (EDA-QA) is a self-administered questionnaire that measures traits and behaviours related to Pathological Demand Avoidance (PDA) in adults (age 18+) with IQ in the normal range (IQ >=80).

Basic information
Statements: 26
Duration: 10–15 minutes
Type: screening tool
Authors: Vincent Egan,
Publishing year: 2018
Seminal paper: The Measurement of Adult Pathological Demand Avoidance Traits (Egan, Linenberg & O’Nions, 2018)

 

Take the test here:


Dr. Natalie Engelbrecht’s rating: 5 stars for appropriate and respectful wording, 5 stars for clarity & lack of ambiguity, and 5 stars for testing accuracy.Dr. Natalie Engelbrecht’s rating: 5 stars for appropriate and respectful wording, 5 stars for clarity & lack of ambiguity, and 5 stars for testing accuracy.


Who the test is designed for


What it tests

The EDA-QA was developed to measure behaviours in clinical accounts of extreme/pathological demand avoidance.

In 2003, PDA was proposed as a separate entity within the pervasive developmental disorders, instead of being classed under pervasive developmental disorder not otherwise specified (PDD-NOS),[2]Pathological demand avoidance syndrome: a necessary distinction within the pervasive developmental disorders (Newson, Le Maréchal & David, 2003) but it’s still considered to be an offshoot of the autism spectrum. Like autism, PDA is a spectrum.


Versions & translations

Non-adults versions are also available:


Taking the test

The EDA consists of 26 statements, giving you 4 choices for each statement:

  1. Not True
  2. Somewhat True
  3. Mostly True
  4. Very True

Scoring

  • Scoring range: 0–78
  • Threshold score: n/a
    • Although a threshold has not been established, scores greater than 45 indicate a high risk of showing features of PDA.
    • Lower scores mean you likely do not.

You can take the test using two methods of scoring:

  1. Self-scoring, if you want documentation of your answers.
  2. Automated scoring (coming soon).

How to generate a total score of the EDA-QA:

Questions 1–26 (apart from questions 14 and 20):

  • Not true = 0
  • Somewhat true = 1
  • Mostly true = 2
  • Very true = 3

Questions 14 & 20:

  • Not true = 3
  • Somewhat true = 2
  • Mostly true = 1
  • Very true = 0

Validity

How reliable, accurate, valid, and up to date is the test?

The EDA-QA is a 26-item self-report adaptation of the observer-rated Extreme Demand Avoidance Questionnaire (EDA-Q) for use with adult populations.[3]Development of the ‘Extreme Demand Avoidance Questionnaire’ (EDA-Q): preliminary observations on a trait measure for Pathological Demand Avoidance (O’Nions et al., 2013)


Dr. Natalie Engelbrecht pointing to the title ‘Discussion’.

Discussion

Dr. Natalie:

  • The test was quick and easy; however, I found some questions a challenge to interpret. Also, I found the wording pathology-based—words like complain, obsessively, and outrageous. That may skew people’s answers, compared to if the wording was more neutral.
  • Some of the questions may pertain more to children, and it should be noted that this test is adapted from the children’s version. This can be seen in questions about temper tantrums, which may appear as swearing rather than throwing ourselves on the floor in public places.
  • I scored 32, which is below the threshold. This made sense to me, as the test is shown to have good sensitivity (the number of people who have the disorder and are identified by the test). The test is also shown to have good specificity (the number of people who do not have the disorder and are identified as not having the disorder by the test).
  • The test is quick to take and easy to self-score.

Martin:

We noticed that perhaps particularly for autistic people, there is a distinct risk of misinterpreting the statements on this test. I sure did. Based on what I understood PDA to be, I felt I probably have it to a degree. But the more research I read on PDA, the more I realize how significantly I misunderstood it. And indeed, I don’t have it; I scored only 13 on the test, which is far below the threshold.

So to avoid the potential of other people misinterpreting the test or PDA itself, below is a list of feedback we received on what autistics felt would make the test clearer, and my responses to their suggestions, based on my understanding of the research literature.

  • #2 — Add examples of what is meant by demand (e.g. housework).
    • I agree, examples would make it clearer.
  • #6 — This statement confuses me, because isn’t that just a description of masking?
    • Indeed it is! Remember that PDA is on the autism spectrum, so one would expect they have a need to mask all the same.
  • #9 — Use the word ‘meltdown’ instead of ‘tantrum’.
  • #11 — “Making them” comes across as almost really hard. It’s very much more subtle and about “getting them to do what you want” rather than forcibly making them.
    • It’s important to note that PDA also constitutes a spectrum of traits, so different statements of the EDA-QA may or may not apply to varying degrees. Having said that, if you have a tendency to tone down statements of the test, I think you might have to concede that it doesn’t apply to you. As autistic people we often have a need to control our environment to limit our overwhelm, but this is very different from the behavior statement #11 alludes to, which is deliberate manipulation to get their way.
  • #13 — I’m not sure that kicking is going to be related to by adults. Inappropriate language, screaming, crying, and slamming things may be more relatable.
    • Yes, we may scream, cry, cuss, etc. during a meltdown. But kicking is not uncommon behavior in people with PDA; they are described as engaging in outrageous acts and lack of concern for their effects, thus drawing parallels with conduct problems and callous-unemotional traits.[7]Pathological demand avoidance: Exploring the behavioural profile (O’Nions, 2013)
  • #14 — ‘Praised’ would be a more appropriate way to put it than ‘a good job’; it’s higher up the scale.
  • #18 — I never actually deny things when caught “red-handed” as an adult. I try to justify why it isn’t exactly what it seems. So an adult would probably show more sophistication in their response.
  • #22 — I don’t think I could giggle if I tried. It’s always loud, inappropriate laughter.
  • #25 — I never quibble. I will argue semantics or try and negotiate.
  • #26 — ‘Moody’ rather than ‘passive’ may be more appropriate.

While PDA is defined as being on the autism spectrum, there are some major differences between the two. I suspect that because we tend to experience overwhelm and executive challenges (avoiding things that stress us, or perpetually putting things off), we identify strongly with the name Demand Avoidance. But the condition is much more than what the name suggests. It actually looks quite a bit like a cluster C personality disorder with some cluster B features (i.e. BPD and histrionic). So be careful with how you interpret the statements of the EDA-QA.

But also be aware that PDA constitutes a spectrum, so you would also find people with mild presentations. Presumably, they would receive a lower score on the test. But you would have to score 45 or higher to potentially qualify for a PDA diagnosis.


Extreme Demand Avoidance Questionnaire for Adults

Please answer the questions thinking about your behaviour during the last six months. Please read each item carefully and fill in the answer that best applies. For each question, you can choose from four possible options: ‘Not’, ‘Somewhat true’, ‘Mostly true’ and ‘Very True’. Please fill in all items. There are no right or wrong answers.

1. I obsessively resist and avoid ordinary demands and requests
2. I complain about illness or physical incapacity to avoid a request or demand
3. I am driven by the need to be in charge
4. I find everyday pressures (e.g. having to go on a routine trip/visit dentist) intolerably stressful
5. I tell other people how they should behave, but do not feel these rules apply to me
6. I mimic other people’s mannerisms and styles (e.g., use phrases adopted from other people to express myself to others)
7. I have difficulty complying with demands and requests from others unless they are carefully presented
8. I take on roles or characters (from TV/real life) and ‘act them out’
9. I show little shame or embarrassment (e.g., I might throw a tantrum in public and not be embarrassed)
10. I invent fantasy worlds or games and act them out
11. I am good at getting around others and making them do as I want
12. I am unaware or indifferent to the differences between myself and figures of authority (e.g. parents, teachers, and police)
13. I will still sometimes have a ‘meltdown’ (e.g., scream, tantrum, hit, or kick) if I feel pressurized to do something
14. I like to be told I have done a good job
15. I have a very rapidly changing mood (e.g., I can switch from affectionate to angry in an instant)
16. I know what to do or say to upset particular people
17. I blame or target a particular person/persons
18. I deny things I have done, even if I am caught “red-handed”
19. I can be distracted (preoccupied) ‘from within’ (i.e., absorbed in my own world)
20. I make an effort to maintain my reputation with other people
21. I sometimes use outrageous or shocking behaviour to get out of doing something
22. I have periods when I have extremely emotional responses (e.g., crying/giggling, becoming furious) to what others would think small events
23. I ensure any social interaction is on my own terms
24. I prefer to interact with others in an adopted role or communicate through props or objects
25. I seek to quibble and change rules set by others
26. I can be passive and difficult to engage



Recommended next steps

After the EDA-QA, consider taking one of the tests below.

RAADS–R

Identifies adults who often “escape diagnosis”
due to a subclinical level presentation

CAT-Q

Measures camouflaging, and can account
for lower scores on other autism tests

Aspie Quiz

Identifies neurodivergence and
potential co-occurring conditions

Online autism tests can play an essential role in the process of self-discovery, and may inform your decision to pursue a formal diagnosis. For a formal assessment, please see a knowledgeable medical professional trained in assessing autism.


Embrace Autism | The EDA-QA | icon Diagnosis

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References

This article
was written by:
dr-natalie-engelbrecht
Dr. Natalie Engelbrecht ND RP is a dually licensed naturopathic doctor and registered psychotherapist, and a Canadian leader in trauma, PTSD, and integrative medicine strictly informed by scientific research. And not only do I happen to be autistic, but my autism plays a significant role in who I am as a doctor and how I interact with and care for my patients and clients.

Disclaimer

Although our content is generally well-researched
and substantiated, or based on personal experience,
note that it does not constitute medical advice.

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