Does anyone else consider the potential impact of propagating a controversial construct, that is clinically unrequired and possibly heavily stigmatising?
Kind of expecting @milton_damian would pick up on this if I do not.
The point here it is a reasonable question, considering PDA strategies are good practice & widely practiced. Critique PDA represents features/ traits from accepted constructs also seems valid. Another point I have forgotten.
Then there is substantial dislike of "Pathological" descriptor & other "problematic" connotations around PDA, like like substantial non-compliance to societal/ cultural norms.
As I said it is a reasonable question, that someone like @milton_damian or anyone LSBU CAS/ CDS group could ask. Although, third panel member is not decided yet.
Simply by conducting PDA research, I am interacting with it, potentially helping to "normalise" it, so it is no-longer controversial. Meh.
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I am slightly upset by this. For those who think PDA is significantly different for autistic persons vs non-autistic persons. I give you 150 reasons that contradicts you (as it includes non-autistic persons): adc.bmj.com/content/88/7/5…
There are other reasons to think, such as processes that develop & maintain PDA behaviours are not specific to PDA. Also need same strategies & protection from reinforcement-based approaches.
I will keep on saying this what matters the most
"criteria will be their clinical utility for the assessment of clinical course and treatment response of individuals grouped by a given set of diagnostic criteria."
A quick thread on reasons why PDA is controversial.
I would appreciate feedback on this, and it is in no particular order.
•The “pathological” descriptor is demeaning and horrible.
•PDA lacks consensus on what it is.
•There is no standardised diagnostic profile or validated tools.
•PDA is not in either main diagnostic manuals.
•PDA risks undermining validity of clinical based language, as it involves an atypical approach to nosology.
So I have been looking at Soppitt's PDA and how it relates to other conditions diagram. This is my version of Soppitt's diagram (2021, p299). I fully spelled out ADHD's name.
This is my version of the diagram. I might change the "Rational Demand Avoidance" to "Pathological Demand Avoidance", as to me its the same thing. Nominally using RDA as it is a better name than PDA.
I have added anxiety in between autism and trauma circles. I have added trauma/ developmental trauma to recognise some view PDA to be developmental (even though that is optional for a PDA dx/ not needed).
@Keirwales If you do have Sammi Timimi on the podcast, please could you ask him, what is their response is to the points around the validity of autism made here: tandfonline.com/doi/full/10.10…
@Keirwales How co-occurring conditions often present differently inside & outside autism, due to simultaneously interacting with each other. Surely, there is something valid there causing co-occurring conditions to present slightly differently?
So I was flicking through these slides of Christie's in 2016 dp.dk/decentrale-enh…
There are some comments towards the end which I think are insightful, not necessarily for good reasons.
Has anyone argued autism is not a disorder, from the APA's definition of disorder?
"A mental disorder is a syndrome characterized by clinically significant disturbance in an individual’s cognition, emotion regulation, or behavior that reflects a dysfunction in the psychological, biological, or developmental processes underlying mental...
... Mental disorders are usually associated with significant
distress or disability in social, occupational, or other important activities. An expectable or culturally approved response to a common stressor or loss,...