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:

  1. 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.
  2. 309.4 Adjustment disorder with mixed disturbance of emotions and conduct
  3. 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."
  4. 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):

  1. significant developmental symptoms (attachment system suppression)
  2. personality disorder symptoms (some NPD/BPD traits)
  3. 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."
  • Amy Baker's empirical research also shows that Parental Alienation is Psychological Child Abuse


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:


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:

Dr. Narrow

Dr. Wamboldt


Other worthwhile topic on this web site:



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