PAS and the APA
By Les Veskrna, MD

The Public Affairs Office of the American Psychological Association has put out the following press release to answer questions generated by PBS’s recent documentary Breaking the Silence: Children’s Stories regarding APA’s official position on Parental Alienation Syndrome:    

 “The American Psychological Association (APA) believes that all mental health practitioners as well as law enforcement officials and the courts must take any reports of domestic violence in divorce and child custody cases seriously.  An APA 1996 Presidential Task Force on Domestic Violence and the Family noted the lack of data to support so-called “parental alienation syndrome”, and raised concern about the term’s use.  However, we have no official position on the purported syndrome.”

Highlighting the word “lack” and using the words “so-called” and “purported” in this press release seems to suggest the APA presumes PAS to be fallacious while, at the same time, uncommitted regarding its validity.

This official statement comes a few days after the APA’s Executive Director of Public and Member Communications, criticized Breaking the Silence for misrepresenting the APA’s position on PAS. 

In spite of these puzzling pronouncements, it is apparent that the APA has, in fact, heretofore made a significant endorsement of the validity of PAS, which may be confirmed by simply searching the content of their website at www.apa.org. 

The APA has well-known guidelines for child-custody evaluations in divorce proceedings. These are the guidelines the APA proposes examiners use when conducting such evaluations. The guidelines refer to three books of Dr. Gardner’s as “pertinent literature.”   One book is completely devoted to the PAS and two make significant reference to the disorder:

• Gardner, R.A. (1989), Family Evaluation in Child Custody Mediation, Arbitration, and Litigation. Cresskill, NJ: Creative Therapeutics, Inc.

• Gardner, R. A. (1992), The Parental Alienation Syndrome: A Guide for Mental Health and Legal Professionals. Cresskill, NJ: Creative Therapeutics, Inc.

• Gardner, R. A. (1992), True and False Accusations of Child Sex Abuse. Cresskill, NJ: Creative Therapeutics, Inc.

Furthermore, the APA has provided a workshop for its member psychologists in recent years that has included a definition and identification of Parental Alienation Syndrome.  In addition, the APA publishes a book (Divorce Wars: Interventions with Families in Conflict by Elizabeth Ellis, PhD, May, 2000) with a chapter specifically devoted to Parental Alienation Syndrome (Chapter 8: A New Challenge for Family Courts).

As we try to understand the motives of the APA and others, who discount the validity of PAS, we must realize that they often do so for reasons other than compelling scientific or empiric evidence. 

Many discount the existence of PAS simply because it is not listed in the most current edition of the America Psychiatry Association’s Diagnostic and Statistical Manual (DSM) of Mental Disorders.  To understand why PAS is not in the most current edition of the DSM requires a little insight into the dynamics of how it is constructed.  First of all, the DSM is an evolving document that reflects knowledge and perspectives at the time it is published.  For example, at one time, the DSM listed homosexuality as a disorder.  Homosexuality, as we all know, is no longer considered a “disorder,” and is no longer described as one in the current DSM.  Conversely, Giles de la Tourette first produced a detailed account of several patients with Tourette’s Syndrome in 1885.  But it was not included in the DSM until 1980.  Inclusion of a disorder in the DSM is a very conservative process that requires a comprehensive review of the scientific literature regarding a particular diagnostic entity.  The criteria and classification system of the DSM are based on a majority opinion of mental health specialists at the time it is published, and therefore does not reflect all valid opinion, and does not reflect all new knowledge and opinion.  The last major update of the DSM was in 1994 (DSM-IV).  The literature review for this edition actually ended in 1992.  Since Dr. Gardner’s first description of Parental Alienation Syndrome was in 1985, there were too few peer-reviewed articles about PAS in the literature at that point in time to warrant submission of PAS to the DSM development workgroup for this (DSM-IV) edition.  Time has now allowed for the proliferation of research and clinical experience with PAS.  There now exists a substantial body of knowledge and understanding of this disorder, so that it’s very possible PAS will appear in DSM-V (which is not scheduled for publication until 2010, or later).

It is important to recognize that sometimes scientific concepts (like PAS) become “controversial” only when they are brought into the courtroom.  This is because attorneys, due to the adversarial nature of our legal system, are required to take an opposite stand and create doubt and uncertainty where it may not otherwise exist as a strategy to win their case   

Finally, dismissing the validity of PAS, by claiming there is a “lack of data” may reflect the influence of a very common informational fallacy:  the notion that something must be true (or not true) because there is no evidence to the contrary.  For how many years did we hear (and believe) the argument from tobacco companies that cigarette smoking was OK because there was no proof that smoking was harmful to health?And now, all cigarette packages carry health warnings.  Absence of proof is not necessarily proof of absence.

The APA deserves significant criticism for only offering a 1996 APA report (Presidential Task Force Report on Domestic Violence and the Family), formed with an immature and incomplete knowledge base regarding PAS, as proof to justify their current position regarding Parental Alienation Syndrome.