Science Isn't Golden

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“Parental Alienation Syndrome:" Another Alarming DSM-5 Proposal

Using a medicalizing label to mask child sexual abuse

PLEASE SEE NEWER UPDATE AS OF JULY 15, 2011, AT END OF THIS ESSAY

PLEASE SEE IMPORTANT UPDATE AS OF JUNE 9, 2011, AT END OF THIS ESSAY


©Copyright 2011 by Paula J. Caplan All rights reserved

Using a medicalizing label to mask child sexual abuse

Among the scientifically unwarranted and socially dangerous proposals that the Diagnostic and Statistical Manual-5 authors have not yet seen fit to rule out is the addition of something its advocates call Parental Alienation Syndrome. This is a medical-sounding term for nothing more than "She's a vengeful woman who's trying to make her children tell horrific lies about their father."

When applied to a parent in a case involving an allegation of child sexual abuse, it is nearly always applied to a woman whose child is allegedly being molested by the father. Despite not yet being in the DSM, PAS has in some courts proven an astonishingly effective vehicle for deflecting the focus from the abuser and simply claiming that the woman must be lying, and coaching her children to lie, because she has the alleged mental illness of PAS. [1] The claim is that without cause, she wants to turn the children against their father.

What often gets short shrift, as a result, is even the consideration of the possibility that the children are truly being molested. Virtually everything that is sometimes a sign that a child is being molested - such as fearfulness when it is time for a visit with the abuser or vaginal bleeding or infection in a 2-year-old - is instead interpreted as further "proof" that the mother has PAS. In these two examples, through use of PAS, the child's fearfulness is cast as the result of the mother's efforts to make the child frightened of the father or terrified of not pleasing her by wanting the visit to take place, and the vaginal problems are assumed to be caused by the mother in order to provide fake evidence of the molesting. If this sounds far-fetched, it is not. I have both done research and consulted in court cases about this.

As Dr. Julie Ancis, who has conducted extensive research about such cases, has noted:

[Richard] Gardner [who invented PAS] claimed that many reports of [child sexual abuse] in the context of divorce cases were false allegations. In this connection, it is important to note that Bala and Schuman (1999) found that only 1.3% of mothers' allegations of abuse by their children's fathers were deemed by civil court judges to be intentionally false, in contrast to 21% of cases in which fathers had made such allegations against mothers. And Meier (2009) reports after reviewing the research that it is a mistaken belief that mothers' allegations in child custody proceedings that fathers have sexually abused their children are usually false. [2]

Gardner not only thought up this label but also condoned adults' sexual assaults on children and said that reports of child sexual abuse were elevated because sexually voyeuristic social workers made them. [1,2] Despite the fact that some judges have quite rightly forbidden the use of the term in their courts, it remains widely used in other courts and sounds more impressive coming from the lips of a testifying mental health professional than "She's just a lying, angry woman."

Ancis writes further:

Gardner's (1998) questionable ethics and clinical judgment are reflected in (but are by no means limited to) the following: (1) he recommends joint interviews with an accused father and child in which the father directly confronts the child about the allegation, and (2) he interprets a child's overt expression of fear of possible retaliation by the father as evidence of the child's embarrassment about lying rather than as possibly a valid fear of a truthtelling child whose father is abusive.

The construct of PAS is unscientific, composed of a group of general symptoms with no empirical basis....

Major professional bodies, including the American Psychological Association, have discredited PAS on the grounds that it is misused in domestic violence cases and that there is no scientific evidence of such a "syndrome." The more recent APA Online document Issues and Dilemmas in Family Violence (http://www.apa.org/pi/essues.html), particularly Issue 5, describes the tendency of family courts to miminize a context of violence, falsely accusing the mother of alienation and granting custody to the father in spite of his history of violence. The National Council on Juvenile and Family Court Judges' 2006 manual states that "parental alienation syndrome or PAS has been discredited by the scientific community" and "should therefore be ruled inadmissible" (p. 19). A number of prominent figures, including Dr. Paul J. Fink, past president of the American Psychiatric Association and president of the Leadership Council on Mental Health, Justice, and the Media, and Professor Jon R. Conte of the University of Washington Social Welfare Doctoral Faculty have also discredited PAS and its lack of scientific basis (see Bruch, 2001).

Because of the use of PAS as a tactic by many CSA perpetrators to influence decision makers and the court system, abused children have been placed in the hands of their abusers (Childress, 2006). It is estimated that "over 58,000 children a year are ordered into unsupervised contact with physically or sexually abusive parents following divorce in the United States" (http://www.leadershipcouncil.org/1/pas/1.html) and that PAS was used in a large number of these cases. [2]


The DSM-5 editors could at any time have already struck PAS from their planned additions but have so far chosen not to.

If this alarms you, and especially if PAS has been used against you, please consider going to dsm5.org before their June 15 cutoff date for input from the public arrives, and send them your concerns. Please urge everyone else you can think of to do the same. The DSM-5 authors will do themselves and the manual's reputation no favors if they include PAS, and they need to hear from people whom the label has harmed.

[1] Paula J. Caplan. (2004) What is it that's being called "Parental Alienation Syndrome"? In Paula J. Caplan & Lisa Cosgrove (Eds.), Bias in psychiatric diagnosis. Lanham, MD: Rowman & Littlefield.

[2] Julie R. Ancis. Parental alienation syndrome. http://awpsych.org/index.php?option=com_content&view=article&id=1...


References from Ancis article quotations

American Psychological Association (APA). (1996). Report on Violence and the Family: Issues and Dilemmas in Family Violence. APA Presidential Task Force on Violence and the Family. Washington, DC: Author. Retrieved from http://www.nnflp.org/apa/intro.html.
Bala, N., & Schuman, J. (1999). Allegations of sexual abuse when parents have separated. Canadian Family Law Quarterly 17, 191-241.
Bruch, C. (2001). Parental Alienation Syndrome and Parental Alienation: Getting it wrong in child custody cases. Family Law Quarterly, 35(3), 527-552. Retreived from http://ezproxy.gsu.edu:3305/HOL/Page?handle=hein.journals/famlq35...
Gardner, R. A. (1998). The Parental Alienation Syndrome (2nd ed.). Creskill, New
Jersey: Creative Therapeutics, Inc.
Meier, J. S. (2009, January). Parental Alienation Syndrome and parental
alienation: Research reviews. National Online Resource Center on Violence Against Women, 1-17. Retrieved from http://www.leadershipcouncil.org/1/pas/1.html
National Council of Family Court Judges (2006). Navigating Custody and
Visitation Evaluations in Cases with Domestic Violence: A Judge's Guide. Retrieved from http://www.ncjfcj.org/content/blogcategory/256/302/

Update:

On June 9, 2011, I was one of three recipients of a letter from DSM-5 Task Force Chair David Kupfer and DSM-5 Task Force Public Representative James McNulty (see my earlier essays on this site about the conference call with them in which I was a minor participant). Kupfer and McNulty said that their letter was in response to a list of questions we had sent in the hope that they could be discussed during our conference call many weeks ago. The news in their letter is that: "...because of the high evidence threshold required, the Task Force is not currently recommending the inclusion of Parental Alienation Syndrome." This is a stunning comment, coming as it does from the heads of a manual in which so many diagnostic categories have been included despite there being no solid scientific evidence even supporting their existence or characteristics. Based on other kinds of decisions the DSM-5 people have been making, it seems unlikely that concern about the lack of scientific evidence is the real reason they have chosen to exclude it. One wonders what might be.

June 13, 2011, note about June 9 update above:

The update I added on June 9 to my original essay was based, as noted, on a letter directed to two other people and me and coming from the Chair of the DSM-5 Task Force and the DSM-5's Public Representative, in which they said that the Task Force is "not currently recommending the inclusion of Parental Alienation Syndrome." Does that mean the label definitely will not go in DSM-5? It does not. Why do I say this? Because (1) the whole history of earlier DSM editions includes many instances of Task Force heads and members making assertions that turn out to be untrue; and (2) some have suggested that the authors of the letter I received on June 9 do not rule out inclusion of some similar or identical but differently-titled category, such as Parental Alienation Disorder rather than Syndrome.

July 15, 2011, note about above essay and updates:

At http://www.dsm5.org/proposedrevision/Pages/Conditions-Proposed-by... you will see that "Parental Alienation Disorder" is still "under review" for DSM-5.

Paula J. Caplan, Ph.D., a clinical and research psychologist, is an Associate at Harvard University's DuBois Institute and former Fellow in Harvard Kennedy School's Women and Public Policy Program. more...

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