What question did this study set out to answer?

Assess the evidence supporting the diagnosis of Pathological Demand Avoidance (PDA) and evaluate current diagnostic tools.

A Systematic Review of Pathological Demand Avoidance (PDA): A Veritable Diagnosis or a Case of Circular Logic?

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Systematic review assesses diagnostic tools for pathological demand avoidance, highlighting significant inconsistencies and biases.

Assess the evidence supporting the diagnosis of Pathological Demand Avoidance (PDA) and evaluate current diagnostic tools.
Comprehensive database search across MEDLINE, EMBASE, and PSYCHINFO.
Independent study selection and quality assessment by two reviewers using Covidence.
Inclusion of English-language empirical studies related to PDA diagnosis.
Identified 12 studies, predominantly in pediatric populations with a high risk of methodological bias.
Noted inconsistency in diagnostic tool application, particularly with EDA-Q and DISCO.
Data collection relied mostly on subjective self-reporting rather than objective measures.

Joe‐Anthony Rotella (2026) studied this question.

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