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Updated: Dec 14, 2025

Multimodal Protocol for Assessing Metacognition and Self-Regulation in Adults with Learning Difficulties
Published on: September 27, 2020
Individual differences, ADHD, adult pathological demand avoidance, and delinquency.
Vincent Egan1, Elinor Bull1, Grace Trundle1
1Centre for Forensic and Family Psychology, University of Nottingham, Yang Fujia Building, Jubilee Campus, Wollaton Road, Nottingham, NG8 1BB, UK.
Attention deficit hyperactivity disorder (ADHD) and emotional instability are key predictors of Pathological Demand Avoidance (PDA) in adults, more so than Autism Spectrum Disorder (ASD). These factors, not PDA itself, are linked to offending behaviors.
Area of Science:
- Psychiatry
- Psychology
- Neurodevelopmental Disorders
Background:
- Pathological Demand Avoidance (PDA) is a developmental disorder associated with challenging behaviors and Autism Spectrum Disorder (ASD).
- Features of PDA overlap with Attention Deficit Hyperactivity Disorder (ADHD) and impulsivity, which are also common in individuals with a history of offending.
Purpose of the Study:
- To investigate if self-reported Autism Spectrum Disorder (ASD), Attention Deficit Hyperactivity Disorder (ADHD), impulsivity, and personality traits predict Pathological Demand Avoidance (PDA) scores.
- To determine which of these constructs predict delinquency.
Main Methods:
- A study involving 132 adult participants (126 with complete data) was conducted.
- Self-reported measures of ASD, ADHD, impulsivity, personality traits (low conscientiousness, low emotional stability), PDA, and delinquency were collected.
Main Results:
- Attention Deficit Hyperactivity Disorder (ADHD) was a significant correlate of PDA (r = 0.71).
- Autism Spectrum Disorder (ASD) showed a small correlation with PDA and did not predict it.
- A combination of higher attention deficit, antagonism, and lower emotional stability predicted 65% of an individual's PDA score.
- PDA scores did not predict delinquency.
Conclusions:
- In adult populations, ADHD, emotional instability, and antagonism are stronger predictors of self-reported PDA than ASD.
- The association between PDA and delinquency may be explained by shared underlying constructs like ADHD and antagonism, which are also linked to offending.
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