La Asociación de Psiquiatría Americana rechaza incluir el SAP en el DSM-5

El lobby feminista impone su criterio ideológico a la APA

Aquí, el informe original de la APA, publicado en enero de 2012 en el Journal of the American Academy of Psychiatry and the Law Online: 'El debate de Alienación Parental pertenece en la Sala de justicia, no al DSM-5' (pincha). Lo reproduzo al final de este post.

Vaya por delante que del informe de la APA se desprende que la existencia de alienación parental queda fuera de toda duda (siendo el tribunal quien debe determinar si en el caso juzgado tiene lugar un proceso de alienación parental o no), y que simplemente la APA descarta considerar a los menores alienados como enfermos mentales. Se trata de un "problema de relación entre padres e hijos" (o entre padres) que suele plantearse en torno a procesos de divorcio y custodia de los hijos. Y la APA entiende que los tribunales son perfectamente capaces de resolver esos problemas sin tener que considerar a los niños envueltos en esos problemas como enfermos mentales. 
Pero, ¿será cierto, como cree la APA, que los tribunales son capaces de entender que hay casos de niños que padecen alienación parental sin necesidad de que un psicólogo o psiquiatra diga que esos niños padecen un síndrome catalogado como enfermedad? Habrá que hacer mucha pedagogía para evitar que los tribunales sigan la interesada y estúpida doctrina del lobby feminista, que no sólo niega que exista un síndrome, sino que niega también, contra toda evidencia y contra este informe de la APA, la existencia de niños que sufren una alienación parental, es decir, niños que llegan a declarar ante un juez que no quieren ver a uno de sus progenitores (e incluso alegan falsos abusos por su parte) simplemente para satisfacer al progenitor que les mantiene alienados respecto al otro. Los tribunales pueden determinar si en un caso concreto hay alienación parental o no la hay sólo si se produce una investigación. Pero ocurre que en España los tribunales de Familia no investigan nada de nada. Y si el caso se lleva en un tribunal de excepción "de violencia de género" (algo que no existe en el país donde la APA tiene su sede, EEUU), entonces la investigación acerca de si hay alienación parental se da por cerrada incluso antes de abrirla.
    
La versión final del DSM-5 sigue estando incompleta, como recuerda la agencia Associated Press, que ha difundido esta noticia tras haber conversado con el Dr. Darrel Regier (vicepresidente del grupo de trabajo sobre el SAP), y no se publicará hasta 2013. Por ello, creo que esta persona tendrá tiempo hasta entonces para resolver una sutil contradicción en la que incurre, a la vista del artículo de prensa (que adjunto más abajo) en el que se publicó el 21 de septiembre lo que la APA había decidido y hecho público en enero de 2012 (¿por qué tanto tiempo de silencio mediático?...), es decir, que el SAP no aparecerá en el DSM. 

La contradicción es ésta:

1. El Dr. Darrel Regier nos informa de que la APA ha resuelto que el SAP no es un trastorno mental de un individuo, sino un "problema de relación entre padres e hijos, o entre padres".

2. Según el medio norteamericano que difunde esta noticia, los defensores del concepto de "alienación parental" (sin mención a síndrome alguno) "se habían preparado para una decisión de la APA para no clasificarlo como síndrome o trastorno, pero mantenían la esperanza de que sería específicamente citado en el apéndice como un ejemplo de un problema de relación padre/hijo". "Pero Regier, en un correo electrónico emitido el viernes" [acaso el mismo viernes 21 de septiembre o quizá el 14 de septiembre, o puede que mucho antes, pues la decisión de la APA tuvo lugar en enero y no se aclara en la noticia publicada de qué "viernes" se trata], dijo que "es muy poco probable", con el fin de eliminar esa esperanza "a pesar de que la versión final del DSM-5 sigue estando incompleta", añade la agencia de prensa norteamericana.

Señor Regier, si en la APA creen que el SAP es "un problema de relación padre/hijo", ¿puede usted explicar por qué "es muy poco probable" que aparezca mencionado así en el apéndice del DSM-5 donde se ocupan ustedes de los problemas padre/hijo? ¿O no puede explicarlo?

NUEVA NOTICIA SOBRE EL SÍNDROME DE ALIENACIÓN PARENTAL, DISTRIBUIDA POR LA AGENCIA ASSOCIATED PRESS.

Viernes, 21 de septiembre 2012

NUEVA YORK (AP) - Rechazando una intensa campaña de "cabildeo" (Campaña de información para influir a favor de algo que se quiere conseguir), un grupo de trabajo de la Asociación Psiquiátrica Americana ha decidido no incluir el controvertido concepto de alienación parental en la edición actualizada de su catálogo de trastornos mentales.

El término expresa cómo la relación de un niño con un padre distanciado puede ser envenenada por el otro progenitor, y hay amplio acuerdo en que a veces se produce en el contexto de los divorcios y disputas de custodia de menores.

Sin embargo, un enconado debate se ha prolongado durante años sobre si el fenómeno debe ser clasificado oficialmente como un trastorno de salud mental por la asociación psiquiátrica, ya que actualiza su Manual Diagnóstico y Estadístico de los Trastornos Mentales por primera vez desde 1994.

El nuevo manual, conocido como DSM-5, no se completará hasta el próximo año, pero la decisión en contra de la clasificación de la alienación parental como un trastorno o síndrome se ha hecho ya.

"El resultado final es que no es un trastorno en un individuo", dijo el Dr. Darrel Regier, vicepresidente del grupo de trabajo de la elaboración del manual. "Es un problema de relación entre padres e hijos, o entre padres. Los problemas en las relaciones en sí mismas no son trastornos mentales".

Regier y sus colegas de APA han estado bajo intensa presión de los individuos y grupos que creen que la alienación parental es un trastorno mental grave que debe ser reconocido formalmente en el DSM-5. Dicen que este paso sería llevar a resultados más justos en tribunales de familia y permitir que más niños de padres divorciados puedan recibir tratamiento para poder reconciliarse con un padre distanciado.

Entre las personas que más se han significado en el otro lado del debate desde la década de 1980, son las feministas y los defensores de las mujeres maltratadas que consideran al "síndrome de alienación parental" como un concepto no probado y peligroso potencialmente útil a los hombres que tratan de desviar la atención de su comportamiento abusivo .

Algunos críticos del concepto dicen que está siendo promovida por psicólogos, consultores y otras personas que podrían beneficiarse si la alienación parental tuviera un carácter más oficial en las disputas judiciales de familia. "En el peor de los casos, ello alinea los bolsillos de ambos, abogados y peritos, por el aumento del número de horas facturables en un caso determinado", escribieron el Dr. Timothy Houchin, un psiquiatra de la Universidad de Kentucky, y tres colegas en un artículo publicado a principios de este año en la revista de la Academia Americana de Psiquiatría y la Ley. "Esto crea un nivel completamente nuevo de debate, en el que sólo pueden participar expertos calificados, sumándose a las ya turbias aguas del testimonio del divorcio", escribieron los autores, con el argumento de que los tribunales podían hacer frente al distanciamiento padre/hijo sin etiquetar al niño como enfermo mental.

Los defensores del concepto de alienación parental se habían preparado para una decisión de la APA de no clasificarlo como un síndrome o trastorno, pero mantenían la esperanza de que sería específicamente citado en el apéndice como un ejemplo de un problema de relación padre-hijo.

Regier, en un correo electrónico emitido el viernes, dijo que es "muy poco probable", a pesar de que la versión final del DSM-5 sigue estando incompleta.

Dr. William Bernet, profesor emérito de psiquiatría en la Escuela de Medicina de la Universidad de Vanderbilt, es el editor de un libro de 2010 que defiende que la alienación parental debería ser reconocida en el DSM-5. Afirma que unos 200.000 niños en los EE.UU. se ven afectados por la enfermedad.

La propuesta Bernet al DSM-5 define el trastorno de alienación parental, por lo general, como "un estado mental de un niño cuyos padres están involucrados en un divorcio altamente conflictivo, y es influido fuertemente por uno de ellos para que rechace relacionarse con el otro sin justificación legítima".

En una entrevista telefónica, Bernet sostuvo que el grupo de trabajo había tomado una decisión sobre la base de factores más allá de la evidencia científica. "Creo que su motivación no es científica, sino que se están dejando llevar por amistades y fuerzas políticas", dijo.
La alienación parental apareció en la escena de la cultura pop hace varios años como consecuencia del amargo divorcio y la batalla de custodia de menores en la que se vieron envueltos los actores Alec Baldwin y Kim Basinger. Baldwin fue atacado por algunos grupos feministas por mencionar el síndrome de alienación parental como fuente del alejamiento respecto a su hija. "La verdad es que la alienación parental es realmente una estrategia legal peligrosa y vendida inteligentemente que ha causado mucho daño a las víctimas de abuso", dijo la Organización Nacional para la Mujer en medio de la controversia.
Bernet, en su propuesta para el grupo de trabajo del DSM-5 , dijo que estaba de acuerdo en que "en algunos casos, el concepto de alienación parental ha sido mal utilizado por padres abusivos para ocultar su conducta".
"Sin embargo, nosotros estamos muy en desacuerdo con tirar al bebé con el agua del baño", escribió Bernet, argumentando que tales abusos se verían disminuidos si los criterios diagnósticos de la alienación parental fueran establecidos.

Texto original

Rebuffing an intensive lobbying campaign, a task force of the American Psychiatric Association has decided not to list the disputed concept of parental alienation in the updated edition of its catalog of mental disorders.
The term conveys how a child’s relationship with one estranged parent can be poisoned by the other parent, and there’s broad agreement that it sometimes occurs in the context of divorces and child-custody disputes.
However, an acrimonious debate has raged for years over whether the phenomenon should be formally classified as a mental health disorder by the psychiatric association as it updates its Diagnostic and Statistical Manual of Mental Disorders for the first time since 1994.
The new manual, known as DSM-5, won’t be completed until next year, but the decision against classifying parental alienation as a disorder or syndrome has been made.
“The bottom line _ it is not a disorder within one individual,” said Dr. Darrel Regier, vice chair of the task force drafting the manual. “It’s a relationship problem _ parent-child or parent-parent. Relationship problems per se are not mental disorders.”
Regier and his APA colleagues have come under intense pressure from individuals and groups who believe parental alienation is a serious mental condition that should be formally recognized in the DSM-5. They say this step would lead to fairer outcomes in family courts and enable more children of divorce to get treatment so they could reconcile with an estranged parent.
Among those on the other side of the debate, which has flared since the 1980s, are feminists and advocates for battered women who consider “parental alienation syndrome” to be an unproven and potentially dangerous concept useful to men trying to deflect attention from their abusive behavior.
Some critics of the concept say it’s being promoted by psychologists, consultants and others who could profit if parental alienation had a more formal status in family court disputes.
“At its worst, it lines the pockets of both attorneys and expert witnesses by increasing the number of billable hours in a given case,” wrote Dr. Timothy Houchin, a University of Kentucky psychiatrist, and three colleagues in an article earlier this year in the Journal of the American Academy of Psychiatry and the Law.
“It creates an entire new level of debate, in which only qualified experts can engage, adding to the already murky waters of divorce testimony,” they wrote, arguing that courts could deal with parent/child estrangement without labeling the child as mentally ill.
Advocates of the concept of parental alienation had been braced for a decision by the APA not to classify it as a syndrome or disorder, but held out hope that it would be specifically cited in an appendix as an example of a parent-child relational problem.
Regier, in an e-mail Friday, said this is “very unlikely,” even though the final draft of the DSM-5 remains incomplete.
Dr. William Bernet, a professor emeritus of psychiatry at the Vanderbilt University School of Medicine, is editor of a 2010 book making the case that parental alienation should be recognized in the DSM-5. He contends that about 200,000 children in the U.S. are affected by the condition.
Bernet’s proposal to the DSM-5 task force defines parental alienation disorder as “a mental condition in which a child, usually one whose parents are engaged in a high conflict divorce, allies himself or herself strongly with one parent, and rejects a relationship with the other parent, without legitimate justification.”
In a telephone interview, Bernet contended that the task force had made up its mind based on factors beyond the scientific evidence.
“I think they’re being motivated not by the science, but being driven by friendships, by political forces,” he said.
Parental alienation surfaced on the pop-culture scene several years ago as a consequence of the bitter divorce and child custody battle involving actors Alec Baldwin and Kim Basinger. Baldwin was assailed by some feminist groups for citing parental alienation syndrome as a source of his estrangement from his daughter.
“The truth is that parental alienation really is a dangerous and cleverly marketed legal strategy that has caused much harm to victims of abuse,” said the National Organization for Women amid the controversy.
Bernet, in his proposal to the DSM-5 task force, said he agreed that “in some instances the concept of parental alienation has been misused by abusive parents to hide their behavior.”
“However, we strongly disagree with throwing out the baby with the bathwater,” he wrote, arguing that such abuse would be curtailed if diagnostic criteria for parental alienation were established.

Read more: Psychiatric group: Parental alienation no disorder - Washington Times http://www.washingtontimes.com/news/2012/sep/21/psychiatric-group-parental-alienation-no-disorder/#ixzz27Vj4fdKD
Follow us: @washtimes on Twitter

Fuente:

 http://www.washingtontimes.com/news/2012/sep/21/psychiatric-group-parental-alienation-no-disorder/

http://www.washingtontimes.com/news/2012/sep/21/psychiatric-group-parental-alienation-no-disorder/?page=2 


A continuación, reproduzco el informe original del grupo de trabajo de la APA acerca de la inclusión o no del SAP en el DSM-5:
http://www.jaapl.org/content/40/1/127.full?sid=98368c28-d537-4319-b26a-5b831fba0b3c

The Parental Alienation Debate Belongs in the Courtroom, Not in DSM-5

1. Timothy M. Houchin, MD,
2. John Ranseen, PhD,
3. Phillip A. K. Hash, DO, PhD and
4. Daniel J. Bartnicki, JD

+ Author Affiliations

1. Dr. Houchin is a Child and Adolescent Forensic Psychiatrist, Dr. Ranseen is Associate Professor, and Dr. Hash is a Fellow in Child and Adolescent Psychiatry, Department of Psychiatry, University of Kentucky, Lexington, KY. Mr. Bartnicki is Attorney-at-Law, Chicago, IL.

1. Address correspondence to: Timothy M. Houchin, MD, Department of Psychiatry, University of Kentucky, 3470 Blazer Parkway, Lexington, KY 40509. E-mail: timothyhouchin@uky.edu.

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Abstract

The DSM-5 Task Force is presently considering whether to adopt parental alienation disorder (PAD) as a mental illness. Although controversy has surrounded PAD since its inception in 1985, pro-PAD groups and individuals have breathed new life into the push to establish it as a mental health diagnosis. In this analysis, we argue that it would be a serious mistake to adopt parental alienation disorder as a formal mental illness in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).

Parental alienation disorder (PAD),¹ formerly and perhaps better known as parental alienation syndrome (PAS), is one of the most controversial diagnoses under consideration for inclusion in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Dr. Darrel Regier, vice-chair of the DSM-5 Task Force, told the Associated Press that he has received more mail regarding PAD than on any other proposed diagnosis.² In this regard, groups for and against PAD's inclusion in the DSM-5 have been gearing up for a battle that should have been over before it began.

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A Note on Alienation

PAS advocates have argued unsuccessfully for decades that it is a mental illness and should be included in the DSM. More recently, parental alienation supporters have renamed PAS as PAD and have formally submitted it for inclusion in DSM-5. Semantics aside, the concept of parental alienation is neither unique nor particularly controversial. Alienation is defined by Merriam-Webster's online dictionary³ as “a withdrawing or separation of a person or a person's affections from an object or position of former attachment.” There are, of course, numerous situations in which persons who are angry with an individual might try to recruit others to their point of view. Politicians frequently engage in alienation tactics to win elections, yet there is little thought to labeling this process as a diagnosis.

In the authors' opinion, there is nothing wrong with using the term parental alienation to describe one parent's “campaign of denigration” (see below) against another. However, there is no good purpose served in deciding to mold an arguably contentious, collateral process of divorce into a diagnosable mental illness. In this article, the reader will see that parental alienation as a psychiatric diagnosis has arisen from emotions emanating from custody battles, publicity, and economics rather than from sound, scientific study.

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The Origin of PAS

Richard Gardner, formerly a psychoanalyst and child psychiatrist on the clinical faculty at Columbia University, introduced the term parental alienation syndrome in his 1985 debut article on the subject.⁴ He would later strike a very academic tone in his refined definition of PAS⁵: The parental alienation syndrome (PAS) is a disorder that arises primarily in the context of child-custody disputes. Its primary manifestation is the child's campaign of denigration against a parent, a campaign that has no justification. It results from the combination of a programing (brainwashing) parent's indoctrinations and the child's own contributions to the vilification of the target parent [Ref. 5, p xx; emphasis in the original].

Over the next decade, Gardner would go on to write prolifically. He founded his own publishing company, Creative Therapeutics, through which he published over 30 books. He used this venue not only to explain and expand his theories regarding PAS, but also to promulgate other problematic theories. For example, he openly supported abolishing child abuse reporting laws⁶ and controversially declared that sexual abuse cases are “turn-ons” for those involved in the court process, including lawyers and judges.⁷ Despite these unusual claims, Gardner was highly sought as an expert witness, testifying in over 400 child custody cases before the end of his career.⁸

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Previous Criticisms of PAS

Controversial since its inception, PAS has compelled many scholars to write articles critical of Gardner's theory. Kelly and Johnston have been noteworthy critics of PAS, writing in their 2001 article, “The Alienated Child, A Reformulation of Parental Alienation Syndrome, ” that “PAS terminology has led to widespread confusion and misunderstanding in judicial, legal, and psychological circles” (Ref. 9, p 250). They also highlighted the lack of empirical support for PAS as a psychiatric diagnosis and the barring of PAS testimony in many courtrooms.

Although they vigorously refuted the validity of PAS as a psychiatric diagnosis, Kelly and Johnston acknowledged in their article that alienating behavior sometimes occurs during the course of child custody disputes. It was in this context that they actually reworked the concept of parental alienation so that both practitioners and the courts could usefully apply it without invoking a mental illness. As one might expect, Gardner took issue with Kelly and Johnston's reformulation, writing a formal rebuttal.¹⁰ Tragically, Gardner ended his own life before he could see this work published in 2004. Having the last word in a spirited series of published exchanges, Kelly and Johnston submitted a response to Gardner's rebuttal that was published in tandem with it.¹¹

Criticisms of PAS have not been limited to mental health professionals, as legal scholars have also been loath to accept the premise that parental alienation should be formally classified as a mental illness. For example, in her 2002 article, “Parental Alienation Syndrome and Alienation: Getting it Wrong in Child Custody Cases,”¹² Carol S. Bruch, JD, voiced concern with Gardner's tendency to cite his own, non-peer-reviewed books and publications on PAS. She noted that in one typical article, Gardner cited 10 sources: 9 writings of his own and 1 by Sigmund Freud. She further refuted Gardner's suggestion that PAS was a generally accepted psychiatric phenomenon by pointing out that, when the validity of PAS was challenged in court, his testimony was often excluded.

In our opinion, Gardner's approach of self-publishing books and then citing himself as an authoritative reference in the scholarly literature went beyond simple self-aggrandizement; it was frankly misleading. We agree with Ms. Bruch that the inaccurate portrayal of PAS as an accepted and credible diagnosis gets it wrong on many levels.

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Lack of an Empirical Basis for PAS

In Gardner's 2004 posthumous publication,¹⁰ he countered critics who consistently pointed out the lack of an empirical basis for PAS as a psychiatric diagnosis. The term empirical, Dr. Gardner argued, could be interpreted to mean direct patient observation and therefore did not have to involve scientific experimentation. He claimed that when the term empirical was interpreted this way, there was ample evidence that PAS stood as a legitimate diagnosis. He then acknowledged that there was only one PAS study (his own) at that time that had actually applied statistical analysis.

In our view, the argument over how one chooses to define the word empirical is semantic. It does not change the fact that there remains a paucity of scientific evidence that PAS (or PAD) should be a psychiatric diagnosis.

Since Gardner's death, others have taken up the crusade to crown his creation of PAS with acceptance in DSM-5. For example, the book, Parental Alienation, DSM-V, and ICD-11,¹³ was published in 2010, claiming to have dozens of professional-level contributors. The book contains the aptly named chapter, “Twenty Reasons Why Parental Alienation Should Be a Diagnosis,” in which the author sought to address the frequently criticized lack of quantifiable, empirical research support for PAS as a psychiatric diagnosis. In the chapter, the author cited two recent studies on the interrater reliability of making the diagnosis of PAS.^14,15 Both studies made use of written clinical vignettes, asking mental health evaluators to read them and determine whether PAS was or was not present. Based on these two studies, the author of “Twenty Reasons” concluded that PAS has achieved interrater reliability. We disagree.

First, only one of these studies was published in a peer-reviewed journal. Second, both studies relied exclusively on written vignettes, with neither study broadening the scope of evaluation to include videos, live patients, or even actors. Third, a combined total of only 45 evaluators actually returned the surveys of the more than 350 that were sent out. Of those surveys that were returned, only 34 were considered useable. In our view, labeling PAS a viable diagnosis based on these limited studies with minimal statistical sway is misguided.

Many scholars of medicine, psychology, and the law have examined the literature regarding PAS. In short, they have consistently encountered a lack of empirical studies published in peer-reviewed journals. Studies of PAS typically exhibit a low number of study participants, causing us to question how some have cited these studies as proof that PAS (or PAD) should be a diagnosis in DSM-5.

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Economics of PAS

As with any heated controversy, one must examine the possible financial motivations that may influence the positions of those engaged in debate. Unfortunately, to get a good sense of PAS's support, one has only to follow the money trail. Litigation stemming from the dissolution of marriage is estimated to be a $28 billion industry.¹⁶ It is no secret that the cost of divorce and custody litigation can add yet another facet of stress to all involved. Adding any further complexity to the problems involved in child custody only serves to compound the financial burden borne by the affected families. A formal diagnosis of PAS, with the obligatory dueling experts testifying at a custody hearing, can become a prime source of fee generation for everyone but the divorcing family.

The Associated Press article cited above² went on to speak about how the diagnosis of PAS might garner more business for those involved in the evaluation of child custody. The article highlighted the view of Elizabeth Kates, an attorney who litigates child custody cases. “It's monetary,” Kates said. “These psychologists and therapists make huge money doing the evaluations and therapies.”

As Kates suggested, additional assessments would be a financial boon to evaluators who already oversee a complicated process with multiple variables that affect cost. In 2001, psychologist Dr. Ira Turkat wrote an article in which he, too, shed light on the economics of child custody evaluations: Custody evaluations can be pricey…. In 2003, the Florida Court of Appeal noted that one psychologist charged $20,000—an amount equal to the parties' entire net worth, and questioned how it could be in a child's best interest for the family's resources to be depleted by fees of this magnitude [Ref. 17, p 8].

To a business-minded, professional child custody evaluator, the adoption of PAS or PAD as a bona fide psychiatric diagnosis in DSM-5 represents a potential windfall opportunity to increase fee revenue. There would almost certainly be more interviewing and testing required by both parents seeking the services of independent experts to testify to the existence of PAS in their children.

It does not take much prognostication to see how inserting PAS into a custody situation may serve to further escalate an already tense situation, adding billable preparation time for lawyers and psychiatrists, while lowering the likelihood of an amicable settlement without a full hearing or trial.

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PAS and Hollywood

Parental alienation has not only caught the attention of mental health professionals, it makes for lively discussion among attorneys, social workers, parents, and even Hollywood celebrities. Actor Alec Baldwin wrote a book on fatherhood¹⁸ that contained the chapter, “Parental Alienation.” He also appeared on various talk shows detailing how he believed that his ex-wife, actress Kim Basinger, had alienated his daughter. While Baldwin's alienation dialogue did not scientifically advance any of the theories of PAS, it did serve to bring PAS into mainstream discussion.

In 2010, PAS was the subject of the hit TV show Law and Order and was later described and quoted in The Huffington Post.¹⁹ In the episode, a defense attorney attempted to use PAS to exculpate a young man accused of murdering his father's girlfriend after reportedly being alienated by his mother. The judge in the episode dismissed the PAS argument, but the American Psychiatric Association is clearly not dismissing PAS(D), at least not for now, as it considers adding PAD as a diagnosis to DSM-5.

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Current Status of PAS

As mentioned earlier, several individuals are leading the charge to include parental alienation in DSM-5. In addition to contributing to Parental Alienation, DSM-V and ICD-11,¹³ many of these individuals have also been active in the Canadian Symposium for Parental Alienation Syndrome. Shortly after the book's publication, this group held a massive pro-PAS forum at the Mount Sinai School of Medicine in New York City.²⁰

A current opponent to PAS's inclusion in DSM-5 is esteemed psychologist Lenore Walker, PhD, who was among the first to describe the battered-woman syndrome. In 2010, she published an article rebutting the assertion in Parental Alienation that PAS is a diagnosable mental illness.²¹ Echoing the criticism of PAS by other writers, Dr. Walker made the sound, if classic, argument that there is a paucity of empirical data to support a formal psychiatric diagnosis of PAS. Also published in 2010 was the textbook, Principles and Practice of Child and Adolescent Forensic Mental Health,²² which credited Drs. Kelly and Johnston with largely replacing Dr. Gardner's PAS paradigm regarding parental alienation.

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Conclusions

Arguments for and against parental alienation as a mental health diagnosis have been intense and ongoing for decades. Gardner started the PAS movement, citing his own, self-published works as evidence that PAS is a mental illness. Gardner's critics have consistently cited the lack of empirical research to support such a diagnosis. Nevertheless, PAS supporters have recently demonstrated a high level of organization, vocalization, and cohesiveness. They have garnered much press and have even received support from Hollywood celebrities.

There is little question that codifying the common phenomenon of alienation as a formalized mental disorder would further complicate many custody disputes, thereby increasing the time and money required to evaluate these already complicated situations. One has to wonder if some of the interest on the part of mental health practitioners supporting the inclusion of PAS or PAD in DSM-5 has more to do with economic self-interest than with any belief that it would lead to improved clinical practice.

Do we believe that alienation by a parent occurs in some cases of child custody? Of course! Divorce is an intense and emotionally charged situation, often bringing out the worst in all parties. Having said this, we believe the courts are quite capable of dealing with this type of scenario without invoking a mental illness to explain a child's malignity against a parent.

At its best, adopting PAS or PAD as a formal diagnosis in the DSM-5 serves only to further confuse mental health practitioners and the courts. At its worst, it lines the pockets of both attorneys and expert witnesses by increasing the number of billable hours in a given case. It creates an entire new level of debate, in which only qualified experts can engage, adding to the already murky waters of divorce testimony. We believe PAS(D) has neither the empiric support nor the clinical relevance to justify its adoption as a mental illness. By all means, each side should be allowed to present a robust argument to gain custody in court, but these conflicted children, caught in the middle, should not be labeled as mentally ill. 

Fuente: http://www.jaapl.org/content/40/1/127.full?sid=98368c28-d537-4319-b26a-5b831fba0b3c

Concluyo:

La existencia de alienación parental es hoy incuestionable