NPO publishes blog articles to inform and to stimulate conversation about issues of importance to NPO's mission. All blog articles express the opinions of the authors as individuals and do not necessarily reflect the views of National Parents Organization, its Board of Directors, or its executives.
DSM V & Parental Alienation Syndrome
One of the principal arguments of the misguided mothers' advocates who seek to discredit Parental Alienation is to say that it has been "debunked" by professionals in the field. This is simply false. We dealt with this issue at the time of our successful Campaign Against PBS's Father-Bashing Breaking the Silence in 2005. During the controversy over the film, the film's feminist supporters insisted that Parental Alienation Syndrome had been discredited and attacked by the American Psychological Association.In the documentary Joan Meier, a professor of clinical law at George Washington University and one of the film's chief spokespersons, stated that PAS "has been thoroughly debunked by the American Psychological Association." Connecticut Public Television, one of the film's producers, put out a press release promoting the film which stated that PAS had been "discredited by the American Psychological Association." Rhea K. Farberman, Executive Director of Public and Member Communications of the American Psychological Association, publicly retorted that these feminist claims are "incorrect" and "inaccurate," and that the APA "does not have an official position on parental alienation syndrome--pro or con." Despite the enormous political pressure put on the APA by misguided women's advocates who oppose PAS, the APA has put out mixed messages about Parental Alienation Syndrome. During the PBS controversy I asked shared parenting advocate Les Veskrna, MD to write an article for my site sorting out the truth about the APA and PAS. According to Veskrna, "The APA has, in fact, heretofore made a significant endorsement of the validity of PAS." Read Veskrna's full piece here. Recently I asked Dr. Veskrna to revisit the issue he wrote about in 2005. His article is below. The Revision of DSM: What"s the Status of Parental Alienation Syndrome? By Les Veskrna, MD The Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association (A.P.A.) and better known simply as the "DSM', specifies uniform criteria for the diagnosis of mental disorders in children and adults. Its primary purpose is to serve as a definitive reference for medical and mental health professionals and researchers in the United States and around the world. Secondarily, because its contents have social and political importance, it is also used by or influences decisions made by government regulatory agencies, pharmaceutical companies, health insurance companies, the court system, and public policy makers among many other entities. The process of updating the DSM has been of considerable interest to those who believe in the existence of Parental Alienation Syndrome and anticipate its validation in DSM-V. Since Dr. Gardner"s original description of PAS was in 1985, there were too few published studies and articles in the literature to warrant its inclusion in the current DSM-IV edition, which was published in 1994. There is hope that time has now allowed for the proliferation of enough research and clinical experience to support PAS being added to DSM-V. The concept of PAS has certainly struck a chord of recognition with a burgeoning number of parents, children, attorneys, judges, and mental health providers, and they now have a name for a behavior pattern that they have either personally experienced or encountered professionally. Beyond the conceptualization of this disorder, there also exists an expanding volume of literature from clinicians and researchers other than Dr. Gardner describing PAS cases and their experience in dealing with these cases. Overall, the progression of the PAS knowledge base appears to be consistent with what one would expect with any newly observed disorder. Is this enough, however, to achieve recognition in DSM-V? Some experts suggest that PAS research is just beginning a higher level of inquiry involving larger samples of subjects, more controlled observations, and greater standardization and reliability of assessment procedures. They believe that until these studies are completed, acceptance by the scientific community – and inclusion in DSM-V – may not yet occur. The very long process for revising DSM-IV began with a Research Planning Conference in 1999. This was followed over the next several years by a series of white papers and more planning conferences to stimulate discussion and establish and refine the research agenda for DSM-V. Several Work Groups, reflecting the diagnostic categories of psychiatric disorders, have been set up and tasked with the revision process. Leading experts in the fields of neuroscience, biology, genetics, statistics, epidemiology, public health, nursing, pediatrics, and social work, were announced as members of these Work Groups by the A.P.A. in May 2008. At some point in a few years a draft of DSM-V diagnostic criteria will be published. A period of comment on this draft will follow succeeded by review and a final revision by the Work Groups. The American Psychiatric Association expects to release the final, approved DSM-V edition in May 2012. It is difficult to know for sure if PAS is being seriously considered for inclusion in DSM-V because Work Group members have been reportedly required by the A.P.A. to sign a confidentiality agreement prohibiting them from individually discussing or releasing anything regarding the development process. Still, there is a lot of information relative to the planning and revision process that has been publicized and available for reading on the A.P.A."s website (http://www.psych.org), including recent summaries of Work Group reports. It may be disheartening to PAS supporters to know that there is no specific reference to PAS in any of this information. However, there is lengthy discussion of a proposed new diagnosis, with features similar to PAS, called a "Relational Disorder'. This diagnosis is defined as "painful, persistent patterns of feelings, behaviors, and perceptions among two or more people in an important personal relationship' (such as a husband and wife or a parent and child), and cannot be due solely to a problem in one member of the relationship. Might a Relational Disorder have a better fate than PAS in DSM-V? Perhaps so because, in contrast to PAS, it is at least being openly discussed. But, it should be pointed out that any diagnosis involving a relationship would first face a significant barrier. That is, all previous editions of DSM have focused on disorders that are present within individuals – not disorders involving two or more people. Therefore, acceptance of a Relational Disorder (or PAS) as a new diagnosis would require a profound conceptual shift among revisers of the DSM. On the other hand, it is evident, judging from what has been made known about the research and revision process so far, that thinking beyond the current DSM-IV framework has been strongly encouraged. Is there anything that anyone else can do to influence the DSM-V development process relative to PAS? The American Psychiatric Association"s website has a "Make a Suggestion' page which invites input from the "wider research, clinical, and consumer communities' for adding a new disorder to DSM-V. These suggestions will be referred to the appropriate DSM-V Work Group to be considered. Submitting a suggestion in this manner entails a brief registration and it is requested that you refer to literature or data in support of your suggestion. This invitation for suggestions appears to include professionals such as attorneys, counselors, educators, psychiatrists, non-psychiatrist physicians, psychologists, psychotherapists, social workers, and others. One might presume "others' could include PAS children or alienated parents. As an alternative to this website, a letter could be sent to the DSM-V Coordinator at the American Psychiatric Association, 1000 Wilson Boulevard, Suite 1825, Arlington, VA 22209-3901. Adopting criteria for the diagnosis of PAS in DSM-V would promote further research involving this disorder, reduce the misuse of PAS in the courts – which is a major concern to critics of PAS – and improve the treatment of children with this disorder. What has been made known about the DSM-V revision process to date represents a mixed picture for PAS supporters. It remains to be seen whether enough clinical research validating PAS will exist at the time the DSM-V revision phase concludes in a few years. If not, the groundwork has certainly been laid for future editions.