DSM-5
Severe parental alienation may rise to the level of Child Psychological Abuse, code V995.51, which DSM-5 defines as “Child psychological abuse is non-accidental verbal or symbolic acts by a child's parent or caregiver that result, or have reasonable potential to result, in significant psychological harm to the child….
According to an older 1995 APSAC definition of psychological abuse that is not found in the DSM-5, examples of psychological abuse of a child include berating, disparaging, or humiliating the child; threatening the child; harming/abandoning----or indicating that the alleged offender will harm/abandon-----people or things that the child cares about.”, according Linda Gottlieb.
According Dr Craig Childress, there are 4 codes relevant to parental alienation in DSM-5:
V995.51 Child psychological abuse, suspected/confirmed (according to Dr. Childress, "child exposure to narcissistic/borderline disordered parenting practices that are inducing prominent child pathology)." This diagnosis invokes a duty to protect (reporting to child protective services). Severe parental alienation is a child protection issue, not a child custody issue.
309.4 Adjustment disorder with mixed disturbance of emotions and conduct
V61.20 Parent Child relational problem: "parental overprotection; excessive parental pressure; arguments that escalate to threats of physical violence; and avoidance without resolution of problems. Cognitive problems may include negative attributions of the other's intentions, hostility toward or scapegoating of the other, and unwarranted feelings of estrangement."
V61.29 Child affected by Parental Relationship distress "This category should be used when the focus of clinical attention is the negative effects of
parental relationship discord (e.g., high levels of conflict, distress, or disparagement) on a child in the family, including effects on the child's mental or other medical disorders." Read this article called "Child affected by Parental Relationship distress", written by Dr. Bernet, along with two co-authors, Wamboldt and Narrow, who were the authors of the same DSM-5 chapter.
Pathogenic parenting practices that involve a role-reversal exploitation of the child as a regulatory object to stabilize and regulate the pathology of the narcissistic / borderline parent create the following symptoms in the child (which constitute significant psychological harm to a child from a caregiver):
significant developmental symptoms (attachment system suppression)
personality disorder symptoms (some NPD/BPD traits)
psychiatric delusional symptoms
Here are some links that further describe why severe parental alieantion is abuse:
An Interview with Craig Childress - "Pathogenic parenting practices by a narcissistic/borderline parent that are creating severe developmental pathology (diagnostic indicator 1), personality disorder pathology (diagnostic indicator 2), and psychotic (delusional) psychiatric pathology (diagnostic indicator 3) in a child, that is then resulting in the loss for the child of a healthy and normal-range affectionally bonded relationship with a normal-range and affectionally available parent, reasonably represents a DSM-5 diagnosis of V995.51 Child Psychological Abuse, Confirmed. If someone disagrees and proposes that it is somehow acceptable for a parent to create severe developmental, personality disorder, and delusionally psychotic psychopathology in a child through highly distorted and aberrant parenting practices, and that this is NOT child psychological abuse, I’m more than happy to engage that debate."
The Exclusion Demand - "A parent attending a child’s activity is entirely normal range and healthy. I recommend all parents everywhere attend their children’s school activities, sporting events, musical recitals, awards ceremonies, etc. There is nothing, absolutely nothing, wrong or problematic about a parent attending a child’s event. Normal-range children are happy and excited when their parent attends an event of the child’s. A child who becomes hyper-anxious and seeks to exclude a parent’s attendance at an event is demonstrating extremely pathological behavior of GREAT CLINICAL CONCERN. There is no – NO – normal-range reason for this symptom display by a child. No normal-range child EVER displays this symptom. Never happens. Never.The only thing that can produce this symptom is extreme psychopathology, either from the targeted-rejected parent or from the allied and supposedly favored parent. But under NO circumstances is this symptom EVER displayed by anything near normal-range children."
Preventing a child from seeing their other parent is child psychological abuse, even without all the manipulation, according to the Massachusetts General Hospital. Click here for the full story.
Parental Alienation is indeed in DSM-5, according to the authors of the relevant sections of DSM-5. Below, see quotes from those authors of the relevant sections of DSM-5. In brief, they say that parental alienation exists, and that it is included under the diagnoses "Child Affected by Parental Relationship Distress (V61.29)" and "Child Psychological Abuse (V995.51)". But they also explain why they left the exact phrase "parental alienation" out of DSM-5, because of fear that "may lead some clinicians to discount a child’s true fears of a parent who has mal-treated him or her" (see below). The 2016 "Child Affected by Parental Relationship Distress" (CAPRD) paper, written by DSM-5 authors, is an endorsement of the existence of "parental alienation" because, for example, they use the phrase "parental alienation" 46 times. See a few relevant quotes below. And see above for more relevant DSM-5 diagnostic codes.
Central Ohio Parental Alienation believes that their concerns that "some clinicians might discount a child's fear of abuse" should be addressed by designating alienated children as a special population, so they can be referred to experts in each of parental alienation, other forms of child abuse, and DV. Furthermore, we believe that Dr. Childress' extended diagnostic checklist identifies severe parental alienation and provides a rigorous, differential diagnosis: a child meeting his 3 criteria is definitely a victim of severe "parental alienation".
The days of under-informed people "claiming" that parental alienation does not exist because it is not in DSM-5 are over.
One author of the 2016 "Child affected by parental relationship distress" (CAPRD) paper below, Dr. Narrow, is listed as the research director for DSM-5, as show on page 7 of DSM-5 (see image below). Another author of the 2016 CAPRD paper, Dr. Wamboldt, is listed as a contributor and advisor to DSM-5, according to page 902 of DSM-5 (see image below). The other authors of papers excerpted below are also part of the Relational Process Work Group that determined what DSM-5 would say about parental alienation:
2012, Family Problems and Family Violence: Reliable Assessment and the ICD-11: "Parental alienation, that is, the child allies himself strongly with one parent (the preferred parent) and rejects a relationship with the other parent (the alienated parent) without cause."
2012, Family Problems and Family Violence: Reliable Assessment and the ICD-11 "It may also be applicable to clear cases of parental alienation syndrome (e.g., Bernet, 2008), where a child is manipulated to reject one parent over the other. The rejected parent's distress and both the parent's and child's affect, cognitions, and behavior can be affected in such instances. All types of parent-child issues that rise to the level of impact required for diagnosis are likely to have significant implications for the child's, and possibly caregiver's, mental health."
2015, Child Maltreatment in DSM-5 and ICD-11: "Child Psychologial Abuse [includes] ... Purposefully indoctrinating a child to consider parent evil, dangerous, or not worthy of affection."
May 2016 "Child affected by Parental Relationship Distress" paper "There have been concerns reported in the literature that acceptance of the “parental alienation”construct may lead some clinicians to discount a child’s true fears of a parent who has maltreated him or her. 35,36 For this reason, the Relational Pro cesses Work Group recommended that it would be better not to include parental alienation as a specific relational problem but instead to use the appropriate broader category, that is, CAPRD, parent–child relational problem (PCRP), and/or child psychological abuse.
December 2016, Houston Chronicle Newspaper: "And several of the manual’s authors have clarified CAPRD to include an entire range of parental alienating behaviors and outcomes"
May 2016 "Child Affected by Parental Relationship Distress" paper: "In some cases of parental alienation, the alienating parent induces the child to say, believe, and falsely remember that he or she was sexually abused by the target parent."
May 2016 "Child Affected by Parental Relationship Distress" paper: "members of the DSM-5 task force never said that they doubted the reality or the importance of parental alienation"
Dec 2013, "PARENTAL ALIENATION: The Handbook for Mental Health and Legal Professionals" book: "Members of WGRP participated in Dr. Narrow's committee, which ultimately recommend that the concept of PA should be in DSM-5, but not the actual words parental alienation"
April 2015, Parent Child Relational Problems Criteria for Assessment" video: "You are eons ahead of where DSM-5 would ever get to. I totally agree. I think ... We were not able to assess the triads. We were happy with getting a dyadic relationship into DSM-5. There is a code in the v-code section for child affected by interparental conflict. There is really good evidence, that children for example, with parents who are having an acrimonious divorce,children do suffer from that"
These two snapshots of DSM-5 pages 7 and 902 show that Dr. Narrow and Dr. Wamboldt had the primary influence over the relevant sections of DSM-5 (and they are the authors of the "Child Affected by Parental Relationship Distress" (CAPRD) paper excerpted above:
Other worthwhile topic on this web site:
Sign the petition to ask the American Psychological Association to update their position statement on parental alienation, to fall inline with DSM-5
Summary of Pathogenic Parenting (a scientific term for severe "parental alienation")
13.4% of surveyed parents say they are alienated from one of their children
Attorney and Lawyer training material for parental alienation
ABC 2020 Exposed Parental Alienation, as did the BBC, 60 minutes, CNN, and Canadian TV
The attachment model of parental alienation that uses only standard and accepted/established psychology, also known as pathogenic parenting, or the trans generational transmission of attachment trauma
American Psychiatric Association Comments on Disordered Parenting
The Harms of Parental Alienation : ACES : Adverse Childhood Experiences Study
Six Peer Reviewed studies show that parental alienation is child abuse