Dr.
Bill Bernet, lead a group of interested professionals in encouraging the DSM 5
editing group to include Parental Alienation Disorder. The new DSM %
was published on May 18, 2013 and is the reference book for
psychiatrists, psychologists and other mental health providers Here
is Dr. Bernet's unedited analysis of the result.
Finally, DSM-5 was published today. The DSM-5 Task Force
told us 2 or 3 years ago that they did not want parental alienation to be a
separate diagnosis in DSM-5, but they thought that parental alienation could be
considered an example of other diagnoses that are in DSM-5.
The
actual words "parental alienation" are not in DSM-5, but there are
several diagnoses that can be used in these cases. I would say the
"spirit" of parental alienation is in DSM-5, even if the words are
not.
Parent-child relational problem now has a discussion in DSM-5, not just a
label. The discussion explains that cognitive problems in parent-child
relational problem "may include negative attributions of the other's
intentions, hostility toward or scapegoating of the other, and unwarranted
feelings of estrangement." That is a pretty good description of a
child's view of the alienated parent, although it is an unfortunate use of the
word "estrangement."
Child psychological abuse is a new diagnosis in DSM-5. It is
defined as "nonaccidental 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." In many instances, the behavior of
the alienating parent constitutes child psychological abuse.
Child affected by parental relationship distress is another new diagnosis in DSM-5.
It should be used "when the focus of clinical attention if 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 physical disorders." That is also a good
description of how parental alienation comes about.
Factitious disorder imposed on another is the DSM-5 terminology for factitious
disorder by proxy or Munchausen disorder by proxy. Its definition is
"falsification of physical or psychological signs or symptoms, or
induction of injury or disease, in another, associated with identified
deception." In some cases, that would describe the behavior of the
alienating parent.
Delusional symptoms in partner of individual with
delusional disorder is the DSM-5 terminology for shared psychotic disorder or
folie a deux. The definition is: "In the context of a relationship,
the delusional material from the dominant partner provides content for
delusional belief by the individual who may not otherwise entirely meet
criteria for delusional disorder."
In
discussing this topic, I would say that the concept of parental alienation is
clearly in DSM-5, although the actual words are not. This is a great
improvement over DSM-IV-TR, especially with the addition of the new diagnoses,
child psychological abuse and child affected by parental relationship distress.
Dr. Bernet is
currently working with PAAO to present a webinar on this subject in the next 2
- 3 weeks. We will notify you of the details shortly.
The next mental health
manual to be revised is the International Statistical Classification of
Diseases and Related Health Problems or the IDC-11. Watch for ways to have your say about Parental Alienation in
time for inclusion there as well.
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