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- W2000616521 abstract "L’évitement pathologique des demandes (pathological demand avoidance [PDA]) désigne un syndrome conceptualisé par E. Newson en 1980 surtout connu au Royaume-Uni et dans les pays d’Europe du Nord. La résistance obsessionnelle aux exigences quotidiennes faisant appel à des stratégies manipulatrices, une sociabilité superficielle marquée par une position égocentrée, une labilité de l’humeur liée à un besoin de contrôle de la relation et un intérêt prononcé pour le monde imaginaire en sont les signes cardinaux. Les difficultés de communication et d’interactions sociales de ces enfants amènent à se poser la question d’une appartenance ou d’une parenté avec les troubles envahissant du développement (TED). Le débat sur ce sujet reste ouvert dans la mesure où certaines descriptions de TED (« psychopathie autistique », syndrome d’Asperger, trouble envahissant du développement non spécifié, autisme atypique…) englobent parfois ce phénotype comportemental. Cet article vise à réactualiser la description clinique, à présenter un outil à visée diagnostique en cours d’élaboration et à discuter les principaux diagnostics différentiels de ce syndrome. Versant sémiologique ou entité clinique, cette pathologie contient en soi suffisamment d’éléments de spécificité pour poursuivre les études afin de préciser sa place dans la nosographie actuelle et dégager des axes pédagogiques et éducatifs qui lui sont propres.The aim of this paper is to inform French clinicians about “pathological demand avoidance” syndrome, also referred to as PDA, described by Elizabeth Newson (1929–2014), professor of developmental psychology at the University of Nottingham in the 1980s. E. Newson discerned a particular behavioral pattern in a subgroup of children who were referred to her for suspicion of autism or Asperger's syndrome without confirmed diagnostic assessment. These children have an inability to tolerate demands imposed upon them and try to resist with strategies of avoidance; being essentially socially manipulative is not compatible with the shared representation of autism. They give an impression of sociability, but they often lack a sense of social identity (e.g. believing themselves to be on a par with or superior to adults), pride or shame. They have mood swings led by need to control their relationship. They appear comfortable in role playing and pretending – often adopting borrowed roles when interacting with others (e.g. relating to peers in the manner of a teacher). In recent years, PDA has attracted increasing clinical attention mainly in the United Kingdom and Northern Europe, but little is known in France. Its validity as well as its place in the nosography are still being debated. E. Newson considered PDA to be a specific pervasive developmental disorder while other clinicians classified it in autism spectrum disorders (ASD). It remains true that PDA is a real clinical problem that imposes a therapeutic challenge: the need for these subjects to control the relationship makes it very difficult to treat. In this article, we illustrate the cardinal signs of this syndrome with a clinical case to facilitate its recognition. We discuss two differential diagnoses: oppositional defiant disorder and ASD. We found that the autistic psychopathy described by Hans Asperger resembles PDA. The interest of E. Newson's work is to highlight the affective and emotional presentation of the symptoms not described in DSM-5 which only emphasizes the deficits of social cognition (deficits in socio-emotional reciprocity, non-verbal communication, restricted interests etc.). Educational approaches effective for PDA differ from “typical” ASD and include novelty, humor and flexibility." @default.
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- W2000616521 date "2008-09-01" @default.
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- W2000616521 title "Une notoriété et des consultations « électroniques » en progression accompagnent les exigences du comité de rédaction de La Presse Médicale" @default.
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- W2000616521 doi "https://doi.org/10.1016/j.lpm.2008.07.002" @default.
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