Reply

Editor:

We would first like to thank the readers who responded to |“The Parental Alienation Debate Belongs in the Courtroom, Not in DSM-5, ” which was published in the January issue.¹ We heard from many renowned clinicians on both sides of the parental alienation debate, which has now raged for nearly 30 years since Dr. Gardner first proposed it as a mental health diagnosis. We would also like to use this forum to respond briefly to some criticisms raised by Ms. Gottlieb and Dr. Pilla in their respective letters.

In her letter, Gottlieb implied that we were dismissive of evidence and research supportive of parental alienation as a psychiatric diagnosis. To the contrary, we performed a broad review of the literature on the subject. We found that, despite the vast amount of oral and written commentary on the topic, there remains a lack of statistically sound, peer-reviewed scientific research to support its inclusion in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).² We are arguing that quantity of writing is not equal to scientifically based research, and the DSM-5 Task Force should take this fact into consideration.

In her letter, Pilla criticized the article for its “use of confusingly inconsistent acronyms.” We agree with her that having interchangeable acronyms for the proposed disorder is confusing. However, the responsibility for this confusion does not belong to us, but to those who transformed Dr. Gardner's parental alienation syndrome into parental alienation disorder shortly before formally proposing its inclusion in the DSM-5.

We stand firm in our opinion regarding the seemingly never-ending debate on parental alienation. We agree that parents sometimes engage in inappropriate persuasion of their children (as do advertisers, educators, coaches, and others). We do not agree that the elevation of parental alienation disorder to the status of a bona fide mental illness is appropriate. In the authors' view, PAD represents both an unproven and unnecessary expansion of the DSM-5.