This page explores autistic demand avoidance, PDA demand avoidance and the types of demand avoidance approaches seen in PDA. For a detailed exploration of other explanations for marked demand avoidance, please see Identifying & Assessing a PDA Profile – Practice Guidance. It’s also important to remember that marked demand avoidance is the most significant, but not the only, trait in a PDA profile. It is sometimes difficult to distinguish underlying causes, but a PDA profile isn’t necessarily always the best explanation for extreme demand avoidance. When demand avoidance is more significant there can be many possible reasons for this – it could be situational relate to physical or mental health or relate to a developmental or personality condition. It’s a natural human trait – avoiding demands is something we all do to different degrees and for different reasons. ‘Demand avoidance’ involves not being able to do certain things at certain times, either for yourself or others, and also refers to the things we do in order to avoid demands.

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Benefits of understanding a PDA profile.

© 2010 Lippincott Williams & Wilkins, Inc. However, reduced reactivity to stressors seems to be only partially responsible for the long-term effect of exercise on BP. Regular physical activity attenuates the BP reaction to psychosocial stressors and delays the development of hypertension. The systolic BP response to public speaking was a weak predictor of future hypertension (p = 0.06) and inclusion of this variable into the Cox model only slightly decreased the strength of the association of physical activity with outcome with HRs = 0.54(0.30–0.96) and 0.59(0.35–0.99), respectively. In a multivariable Cox regression, the hazard ratio (HR) was 0.49(CI,0.27–0.89) for clinic hypertension and 0.56(CI,0.33–0.95) for ambulatory hypertension.

Active subjects were less likely to develop incident hypertension than sedentary ones. During a median follow-up of 71 months, ambulatory BP did not virtually change in the active subjects (−0.9 ± 7.8/−0.0 ± 4.7 mmHg) and increased in their sedentary peers (2.8 ± 9.8/3.2 ± 7.4 mmHg, p versus active = 0.08/0.003). Among the hypertensives, sedentary subjects showed increased BP reactivity to the speech test (45.2 ± 22.6/22.2 ± 11.5 mmHg, p < 0.01/ < 0.001 versus controls), while physically active subjects had a response similar to that of controls (35.4 ± 18.5/18.5 ± 11.5 mmHg, p = n.s.). The BP response to public speaking was greater in the hypertensive (42.0 ± 21.7/21.0 ± 11.9 mmHg) than the normotensive (31.2 ± 17.3/16.0 ± 7.8 mmHg) subjects (age-and-sex-adjusted P = 0.018/0.009). Data were adjusted for age, sex, body mass index, parental hypertension, smoking, alcohol, coffee use, and baseline BP. Definition of incident hypertension was based either on clinic or 24-hour BP measurement. The blood pressure (BP) response to public speaking was assessed with beat-to-beat non-invasive finger recording. We assessed 75 sedentary and 44 active stage 1 hypertensive subjects aged 29 ± 9 years never treated for hypertension with consistent activity habits during the follow-up, and 63 normotensive subjects of control. We investigated the effect of regular physical activity on the hemodynamic response to a psychophysiological stressor, public speaking, and on development of hypertension. Exaggerated stress reactivity may contribute to the development of hypertension and cardiovascular disease.

Stress reactivity definition