Saturday, May 21, 2011

Parental Alienation Disorder: Why Label Children with a Mental Diagnosis?

also: Revealed, six decades of 'ritual' child abuse: Catholic schools and orphanages damned in report

Parental Alienation Disorder: Why Label Children with a Mental Diagnosis?

Journal of Child Custody Volume 7, Issue 4, 2010, Pages 266 - 286 Authors: Lenore E. Walker; David L. Shapiro
DOI: 10.1080/15379418.2010.521041

The proposal to include Parental Alienation Disorder (PAD) in the new proposed Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) creates a host of problems. The first major problem is the labeling of children with a mental disorder who may simply be reacting with anger to the changes in their lives from the separation and divorce of their parents by rejecting one parent and aligning with the other. Diagnosis may bring with it shame and have a chilling impact on parents report of domestic violence.

Although proponents of PAD are aware that it is inappropriate to diagnose children who have been exposed to child abuse and/or domestic violence with PAD, they do not clarify how to make such differential diagnoses. It is suggested that there are insufficient empirical data to differentiate abused and traumatized children from those who are alienated or estranged from the rejected parent.

Nor are there sufficient scientific data to account for other child vulnerabilities such as neurological immaturity, Attention-Deficit/Hyperactivity Disorder (ADHD), other anxiety and mood disorders, or oppositional defiant disorder. There are too few comparisons between the risks and benefits of adding a new diagnosis of childhood disorders to justify its inclusion in the DSM-V.

Appropriate intervention strategies recommended for PAD children include contact with the rejected parent, which differ widely from trauma victim/survivors who need assurance of safety and healing before contact is re-established. Ethical standards that may be impacted by this new diagnosis and admissibility issues raised by its predecessor, Parental Alienation Syndrome (PAS), are also discussed by the authors.

"As discussed, alienation is almost always alleged when the child does not want to be with a parent when there does not appear to be any ‘rational’ reason for these feelings. Of course, the definition of ‘‘rational’’ in these cases remains totally subjective to the person making the evaluation. Although proponents of labeling these children with PAD claim that using this label will assist in formulation of treatment goals and techniques, there are no empirical data to support this position (Bernet, 2010). Using the definition put forward by the American Psychological Association (APA) which requires two scientific studies replicating each other, there are no empirically validated interventions that support evidence that forcing a child to be with an unwanted parent will promote mental health." (p.270-271)

"PROPOSED DIAGNOSTIC CRITERIA FOR PAD AND MAKING A DIFFERENTIAL DIAGNOSIS....Perhaps the most egregious part of this newly proposed diagnosis is the impossibility of making a differential diagnosis based on the child’s signs and symptoms and not the parents’ alleged behavior. Johnston (2010) discussed the confusion currently in the courts dealing with PAS=PAD and, in particular, defining who is alienated, the rejected parent or the child? There are so many explanations other than alienation for a child’s rejection of a parent during separation or divorce that to give children a new mental illness diagnosis is neither necessary nor appropriate. Surely anxiety disorders including PTSD from abuse are primary as has been discussed herein, as are other mood disorders, particularly depression. The criteria for children’s depression often include acting-out behavior and rejection of people and things that they used to like to do.
(p. 276 - 277)

"It is not appropriate to diagnose a child with a mental illness based on the parents’ behavior. In many cases known to the authors, both in practice and in supervision of other forensic evaluators, the child’s behavior could have been diagnosed as an adjustment disorder with anxiety or depression. Separation and divorce often means a new home or even two homes, new schools, new friends, and new schedules. Even when all goes well this can be a daunting challenge for most children." (p. 277)

full article pdf and web page until 12/31/11

Revealed, six decades of 'ritual' child abuse: Catholic schools and orphanages damned in report
By Tom Kelly 21st May 2009
Abuse was 'endemic' in childrens' institutions
Safety of children in general was not a consideration
No abusers will be prosecuted
Victims banned from launch of shocking report

Church leaders and government watchdogs covered up 'endemic' and 'ritualised' abuse of thousands of children in Roman Catholic schools and orphanages in the Irish Republic, a shocking report revealed yesterday.

For six decades, priests and nuns terrorised boys and girls in the workhouse-style schools with sexual, physical and mental abuse.

But officials in Ireland's Catholic Church shielded paedophile staff from arrest to protect their own reputations despite knowing they were serial attackers, according to the 2,600-page report, which took nine years to complete.

Irish government inspectors also failed to stop the chronic beatings, rape and humiliation, it found.

About 35,000 children and teenagers who were orphans, petty thieves, truants, unmarried mothers or from dysfunctional families were sent to Ireland's network of 250 Church-run industrial schools, reformatories, orphanages and hostels from the 1930s up until the early 1990s.

The report by Ireland's Commission to Inquire Into Child Abuse found 'a climate of fear, created by pervasive, excessive and arbitrary punishment, permeated most of the institutions and all those run for boys'.

It added: 'Children lived with the daily terror of not knowing where the next beating was coming from.'

Judge Sean Ryan, who chaired the commission, said that when confronted with evidence of sex abuse, religious authorities responded by moving the sex offenders to another location, where in many instances they were free to abuse again.

'There was evidence that such men took up teaching positions sometimes within days of receiving dispensations because of serious allegations or admissions of sexual abuse,' the report said.

'The safety of children in general was not a consideration.'....
The report found that molestation and rape were 'endemic' in boys' facilities, chiefly run by the Christian Brothers order.

Girls supervised by orders of nuns, chiefly the Sisters of Mercy, suffered much less sexual abuse but frequent assaults and humiliation designed to make them feel worthless.

'In some schools a high level of ritualised beating was routine,' the report said.

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