Scholarly rumors: Citation analysis of vast misinformation regarding parental alienation theory.

Misinformation is widespread in political discourse, mental health literature, and hard science. This article describes recurrent publication of the same misinformation regarding parental alienation (PA), that is, variations of the statement: "PA theory assumes that the favored parent has caused PA in the child simply because the child refuses to have a relationship with the rejected parent, without identifying or proving alienating behaviors by the favored parent." Ninety-four examples of the same misinformation were identified and subjected to citation analysis using Gephi software, which displays the links between citing material and cited material. The recurrent misinformation reported here is not trivial; these statements are significant misrepresentations of PA theory. Plausible explanations for this trail of misinformation are the psychological mindset of the authors (i.e., confirmation bias) and the authors' writing skills (e.g., sloppy research practices such as persistent use of secondary sources for their information). The authors of this article recommend that publications containing significant misinformation should be corrected or retracted.

Definitions and terminology regarding child alignments, estrangement, and alienation: A survey of custody evaluators.

Parental alienation (PA) is a highly consequential family dynamic that causes harm to children and parents. While many mental health and legal professionals agree that PA is common and potentially very harmful to children, there is still the appearance that there is controversy and discord in the field. The purpose of this study was to test the extent of consensus in the field regarding the basic tenets of PA theory. Specifically, 11 key terms related to PA were identified through expert input and preliminary field-testing. An on-line survey was created specifically for the study to assess level of agreement with these key terms among custody evaluators. This profession was selected because of their high degree of training and experience with a variety of family conflict situations; 119 child custody evaluators selected as members of a professional custody evaluator listing (88% response rate) rated their endorsement of these 11 key definitions with response options including: strongly agree, agree, neither agree nor disagree, disagree, and strongly disagree. Results revealed that roughly 80% of respondents agreed or strongly agreed with each of the 11 definitions. These results demonstrate a high degree of consensus and should guide future trainings of legal and mental health professionals to ensure a common language and understanding of this phenomenon.

The Five-Factor Model for the Diagnosis of Parental Alienation.

Although the phenomenon that we know as parental alienation (PA) had been described in the mental health and legal literature for many years, it was given its name-parental alienation syndrome-by Richard Gardner in 1985. As time went on, most writers abandoned the use of the word syndrome and simply referred to this mental condition as parental alienation. The definition of PA is a mental state in which a child-usually one whose parents are engaged in a high-conflict separation or divorce-allies strongly with one parent (the favored parent) and rejects a relationship with the other parent (the alienated parent) without a good reason. Of course, it is a major loss for a child to experience the removal of a parent from their life in that manner. The purposes of this commentary are to explain definitions and distinctions related to PA; describe the Five-Factor Model (FFM) for the identification of PA; and offer clinical, legal, and training implications stemming from an understanding of PA.

Measuring the Difference Between Parental Alienation and Parental Estrangement: The PARQ-Gap.

Parental alienation (rejection of a parent without legitimate justification) and realistic estrangement (rejection of a parent for a good reason) are generally accepted concepts among mental health and legal professionals. Alienated children, who were not abused, tend to engage in splitting and lack ambivalence with respect to their parents; estranged children, who were maltreated, usually perceive their parents in an ambivalent manner. The hypothesis of this study was that a psychological test-the Parental Acceptance-Rejection Questionnaire (PARQ)-will help to distinguish severely alienated from nonalienated children. The PARQ, which was used to identify and quantify the degree of splitting for each participant, was administered to 45 severely alienated children and 71 nonalienated children. The PARQ-Gap score-the difference between each child's PARQ: Father score and PARQ: Mother score-was introduced and defined in this research. Using a PARQ-Gap score of 90 as a cut point, this test was 99% accurate in distinguishing severely alienated from nonalienated children. This research presents a way to distinguish parental alienation from other reasons for contact refusal. The PARQ-Gap may be useful for both clinicians and forensic practitioners in evaluating children of separating and divorced parents when there is a concern about the possible diagnosis of parental alienation.

An Objective Measure of Splitting in Parental Alienation: The Parental Acceptance-Rejection Questionnaire.

Both clinicians and forensic practitioners should distinguish parental alienation (rejection of a parent without legitimate justification) from other reasons for contact refusal. Alienated children-who were not abused-often engage in splitting and lack ambivalence with respect to the rejected parent; children who were maltreated usually perceive the abusive parent in an ambivalent manner. The purpose of this study was to assess the usefulness of the Parental Acceptance-Rejection Questionnaire (PARQ) in identifying and quantifying the degree of splitting, which may assist in diagnosing parental alienation. Results showed that severely alienated children engaged in a high level of splitting, by perceiving the preferred parent in extremely positive terms and the rejected parent in extremely negative terms. Splitting was not manifested by the children in other family groups. The PARQ may be useful for both clinicians and forensic practitioners in evaluating children of divorced parents when there is a concern about the possible diagnosis of parental alienation.

Child Affected by Parental Relationship Distress.

OBJECTIVE: A new condition, "child affected by parental relationship distress" (CAPRD), was introduced in the DSM-5. A relational problem, CAPRD is defined in the chapter of the DSM-5 under "Other Conditions That May Be a Focus of Clinical Attention." The purpose of this article is to explain the usefulness of this new terminology. METHOD: A brief review of the literature establishing that children are affected by parental relationship distress is presented. To elaborate on the clinical presentations of CAPRD, four common scenarios are described in more detail: children may react to parental intimate partner distress; to parental intimate partner violence; to acrimonious divorce; and to unfair disparagement of one parent by another. Reactions of the child may include the onset or exacerbation of psychological symptoms, somatic complaints, an internal loyalty conflict, and, in the extreme, parental alienation, leading to loss of a parent-child relationship. RESULTS: Since the definition of CAPRD in the DSM-5 consists of only one sentence, the authors propose an expanded explanation, clarifying that children may develop behavioral, cognitive, affective, and physical symptoms when they experience varying degrees of parental relationship distress, that is, intimate partner distress and intimate partner violence, which are defined with more specificity and reliability in the DSM-5. CONCLUSION: CAPRD, like other relational problems, provides a way to define key relationship patterns that appear to lead to or exacerbate adverse mental health outcomes. It deserves the attention of clinicians who work with youth, as well as researchers assessing environmental inputs to common mental health problems.

Associations between Exposure to Alienating Behaviors, Anxiety, and Depression in an Italian Sample of Adults.

The aim of this study was to examine associations between exposure to alienating behaviors (ABs) and anxiety and depression as mediated through psychological maltreatment and parental bonding in a sample of Italian adults in the community. Five hundred and nine adults were given a measure of exposure to ABs, the Baker Strategy Questionnaire; the Psychological Maltreatment Measure; the Parental Bonding Instrument; the State-Trait Anxiety Inventory-Y; and the Beck Depression Inventory-II. Exposure to ABs was associated with psychological maltreatment, which was associated with parental bonding, which was associated with each of the three mental health outcomes: depression, state anxiety, and trait anxiety. The authors conclude that exposure to ABs in childhood represents a risk factor for subsequent poor mental health.

Symptom Checklist-90-Revised scores in adult children exposed to alienating behaviors: an Italian sample.

This study addresses a particular form of child psychological maltreatment, exposing a child to alienating behaviors in the context of a high degree of conflict between the parents. The objective of this research was to identify retrospectively the alienating behaviors that occurred in an Italian sample of children and the reported associated psychosocial symptoms. Seven hundred and thirty-nine adults in Chieti, Italy, completed an anonymous and confidential survey regarding their childhood exposure to parental alienating behaviors and measures of current symptomatology. About 75% of the sample reported some exposure to parental alienating behaviors; 15% of the sample endorsed the item, "tried to turn me against the other parent." The results revealed strong and statistically significant associations between reported exposure to parental alienating behaviors and reports of current symptomatology.

Parental alienation, DSM-5, and ICD-11: response to critics.

There has been considerable interest among forensic practitioners in the proposals that parental alienation be included in the next editions of the Diagnostic and Statistical Manual of Mental Diseases (DSM) and The International Classification of Diseases (ICD). However, there has also been a great deal of misunderstanding about the proposals, and misinformation has been expressed in professional meetings, on websites, and in journal articles. In this article we address four common misunderstandings regarding parental alienation: that there is a lack of research to support it as a diagnosis; that adopting parental alienation as a diagnosis will lead to serious adverse consequences; that the advocates of parental alienation are driven by self-serving or malevolent motives; and that Richard Gardner should be criticized for self-publishing his description of parental alienation syndrome.

Ridiculous statements by mental health experts.

When mental health experts express their opinions in testimony, reports, and articles in professional literature, it is expected that their statements will accurately reflect the current state of knowledge. Experts may disagree about the data that they collected. In some cases, however, disagreement occurs because an expert has employed a methodology that is far outside usual procedures or simply disregarded objective facts. When that occurs, the expert's opinions may be considered ridiculous. The author presents examples of ridiculous statements by mental health experts and provides suggestions for how a forensic practitioner might address ridiculous statements by mental health experts.

Falsas denúncias e o Diagnóstico diferencial das alegações de abuso sexual / False statements and the differential diagnosis of abuse allegations

O objetivo deste artigo é classificar e definir as várias formas de alegações de abuso sexual infantil, uma vez que os psiquiatras infantis não têm uma forma consistente de classificá-las e em função de não haver definições gerais aceitas sobre as muitas formas as quais as alegações podem surgir. Método: o autor fez uma revisão de 40 artigos, capítulo e livros que contém exemplos de falsas alegações de abuso sexual feitas por crianças e seus cuidadores. Resultado: Este artigo explica os conceitos de programação, sugestão, fantasia, delírio, má interpretação, mentira inocente, mentira deliberada, confabulação, pseudologia fantástica, hiperestimulação, contágio grupal e substituição de figura do agressor. Conclusão: A correta classificação das alegações de abuso sexual é importante tanto no campo clínico como no campo forênsico da psiquiatria. As definições neste artigo, são baseadas em experiências clínicas que deverão ser estudadas através de pesquisas sistemáticas. J.Am. Acad. Child Adoles. Psychiatry, 1993, 32, 5: 903-910.

Objective: Because child psychiatrists do not have a consistent way to classify the untruthful child and because there are no generally accepted definitions of the many ways in which false statements occur in allegations of abuse, the objective of this paper is to classify and define the various ways in which false statements occur in allegations of abuse. Method: the author reviewed 40 articles, chapters, and books that contained examples of false statements made by children or caregivers in the context of an abuse allegation. Results: this paper clarifies the concepts of indoctrination, suggestion, fantasy, delusion, misinterpretation, miscommunication, innocent lying, deliberate lying, confabulation, pseudologia phantastica, overstimulation, group contagion, and perpetrator substitution. Conclusion: the correct classification of abuse allegations is important in both clinical and forensic child psychiatry. The definitions in this paper, which are based on clinical experience, should be studied through systematic research.

Falsas denúncias e o Diagnóstico diferencial das alegações de abuso sexual / False Statements and the Differential Diagnosis of Abuse Allegations

O objetivo deste artigo é classificar e definir as várias formas de alegações de abuso sexual infantil, uma vez que os psiquiatras infantis não têm uma forma consistente de classificá-las e em função de não haver definições gerais aceitas sobre as muitas formas as quais as alegações podem surgir. Método: o autor fez uma revisão de 40 artigos, capítulo e livros que contém exemplos de falsas alegações de abuso sexual feitas por crianças e seus cuidadores. Resultado: Este artigo explica os conceitos de programação, sugestão, fantasia, delírio, má interpretação, mentira inocente, mentira deliberada, confabulação, pseudologia fantástica, hiperestimulação, contágio grupal e substituição de figura do agressor. Conclusão: A correta classificação das alegações de abuso sexual é importante tanto no campo clínico como no campo forênsico da psiquiatria. As definições neste artigo, são baseadas em experiências clínicas que deverão ser estudadas através de pesquisas sistemáticas. J.Am. Acad. Child Adoles. Psychiatry, 1993, 32, 5: 903-910.(AU)

Objective: Because child psychiatrists do not have a consistent way to classify the untruthful child and because there are no generally accepted definitions of the many ways in which false statements occur in allegations of abuse, the objective of this paper is to classify and define the various ways in which false statements occur in allegations of abuse. Method: the author reviewed 40 articles, chapters, and books that contained examples of false statements made by children or caregivers in the context of an abuse allegation. Results: this paper clarifies the concepts of indoctrination, suggestion, fantasy, delusion, misinterpretation, miscommunication, innocent lying, deliberate lying, confabulation, pseudologia phantastica, overstimulation, group contagion, and perpetrator substitution. Conclusion: the correct classification of abuse allegations is important in both clinical and forensic child psychiatry. The definitions in this paper, which are based on clinical experience, should be studied through systematic research.(AU)

Practice parameter for the assessment and treatment of children and adolescents with depressive disorders.

This practice parameter describes the epidemiology, clinical picture, differential diagnosis, course, risk factors, and pharmacological and psychotherapy treatments of children and adolescents with major depressive or dysthymic disorders. Side effects of the antidepressants, particularly the risk of suicidal ideation and behaviors are discussed. Recommendations regarding the assessment and the acute, continuation, and maintenance treatment of these disorders are based on the existent scientific evidence as well as the current clinical practice.

Bad nature, bad nurture, and testimony regarding MAOA and SLC6A4 genotyping at murder trials.

Recent research-in which subjects were studied longitudinally from childhood until adulthood-has started to clarify how a child's environment and genetic makeup interact to create a violent adolescent or adult. For example, male subjects who were born with a particular allele of the monoamine oxidase A gene and also were maltreated as children had a much greater likelihood of manifesting violent antisocial behavior as adolescents and adults. Also, individuals who were born with particular alleles of the serotonin transporter gene and also experienced multiple stressful life events were more likely to manifest serious depression and suicidality. This research raises the question of whether testimony regarding a defendant's genotype, exposure to child maltreatment, and experience of unusual stress is appropriate to present during the guilt or penalty phases of criminal trials, especially when capital punishment is a consideration. The authors present their experience in genotyping criminal defendants and presenting genetic information at criminal trials.

An evidence-based approach for estimating present and future damages from child sexual abuse.

This article illustrates the use of evidence-based practice to develop conclusions for a forensic report. The authors present a case vignette in which an early adolescent boy was sexually abused by an employee of a private school, and a lawsuit ensued. They explain how to utilize relevant research regarding the prognosis of victims of sexual abuse to address the forensic issues of psychological injury and future damages. It is notable that the two authors, who have at times testified on opposite sides of similar cases, were able to agree on conclusions that were based on relevant published research.

Practice parameter for the assessment and treatment of children and adolescents with substance use disorders.

This practice parameter describes the assessment and treatment of children and adolescents with substance use disorders and is based on scientific evidence and clinical consensus regarding diagnosis and effective treatment as well as on the current state of clinical practice. This parameter considers risk factors for substance use and related problems, normative use of substances by adolescents, the comorbidity of substance use disorders with other psychiatric disorders, and treatment settings and modalities.