of Medicine that utilizes MEDLINE) search performed on 09-13-2007 by the writers of this article for keywords “parental alienation” and “parental alienation syndrome” produced six peer- reviewed articles dealing with the topics. Gardner has no peer-reviewed articles related to PAS on PubMed. The extent of published clinical data on PAS (not from PubMed) involved a description of “sixteen selected cases” of potential PAS7


, a far cry from the empirical rigor


needed to establish a valid syndrome. A Columbia University review committee recently concluded that Gardner “was careful to qualify any conclusions as his own opinion,” and a letter from the Dean of Faculty advised against any “claim that (his views were) facts based on research”8


. From the standpoint of scientific


validity, PAS is an entity based only on conjecture. Parental alienation syn- drome is couched in descriptive criteria that give the illusion that it exists as a syndrome, simply because it has descrip- tive criteria. Moreover, the criteria are emotionally and intellectually riveting, seemingly familiar and feasible enough to allow for the inductive leap that PAS must be valid. However superficially appealing some of criteria may be, PAS has not demonstrated scientific validity through empirical tests of any kind. Es- tablishing a syndrome requires evidence on reliability of recognition, specificity of criteria, reliability among diagnosti- cians, discriminate validity of the entity, sensitivity and specificity of standard- ized interviews and other tests, and other empirical factors. The American Bar Association (ABA) Section of Family Law published a noteworthy descriptive study of programming and brainwash- ing based on participation in and review of nearly 1000 cases over 12 years; the findings produced demographic data,


7


The Parental Alienation Syndrome: An Analysis of Sixteen Selected Cases. Dunne J and Hedrick M. Journal of Divorce and Remarriage, Vol. 21, p 21-38 1994


8


The Evidentiary Admissibility of Parental Alienation Syndrome: Science, Law, And Policy. Hoult J. Children’s Legal Rights Journal. Vol. 26, No. 1, Spring 2006


Winter 2008 12


described eight stages of programming/ brainwashing, delineated numerous techniques of alienating behavior, and discussed motivational factors9


. Even


though the research and publication (in 1991) of the ABA publication over- lapped with the timeline and content of Gardner’s work, the authors did not even allude to PAS.


trination in any section. The DSM-IV-TR does not come close to addressing alien- ation behavior, but there are relevant “v-codes” (entities worthy of clinical attention but are not defined as disor- ders) worth considering in a discussion estrangement/alienation behavior: “neglect/abuse of a child” (for obvi- ous reasons), “parent-child relational


From the standpoint of scientific validity, PAS is an entity based only on conjecture.


One of the most common refutations


of PAS is that it is not listed in the most recent diagnostic and statistical manual produced by the American Psychiatric Association (APA), the DSM-IV-TR10


,


and thereby is not a valid psychiatric syndrome. The guiding principle for in- clusion in the DSM-IV is “sufficient data to justify its inclusion in the DSM-IV by 1994,” according to the DSM-IV-TR website (www.dsmivtr.com). As dis- cussed above, there was not sufficient data to justify inclusion of PAS then and there is none now. Further, the nature of PAS as it is constructed, with presumed etiology interwoven with presumed symptoms as criteria, PAS cannot be verified11


hopelessly unscientific Gardner wrote that he did not submit PAS for review by the DSM-IV committee12


.


The DSM-IV does not address programming, brainwashing, or indoc-


9


Children Held Hostage. Dealing with Programmed and Brainwashed Children. Clawar SS and Rivlin BV. 1991. American Bar Association, Chicago, IL.


10


American Psychiatric Association: Di- agnostic and Statistic Manual of Mental Disorders, Fourth Edition, Text Revision, Washington, D.C., American Psychiatric Association, 2000.


11


Rethinking Parental Alienation and Re- designing Parent-Child Access Services for Children Who Resist or Refuse Visita- tion, Johnston, J., Paper presented at the International Cnference on Supervised Visitation, Munich, Germany July 9 -10, 2001


Parental Alienation Syndrome: Sixteen Years Later, Gardner RA. 45 Acad. F. 10 (2001).


Trial Reporter


problem,” and “acculturation problem” (op cit)10


. Parent-child relational prob-


lem is a vague descriptor of ineffective discipline, overprotection, and/or im- paired communication (which could easily apply during divorce). A classic textbook that attempted to incorpo- rate the logic of DSM-IV stretched the logic of acculturation problem to involve “brainwashing” as originally formulated, as a forced “culture shock” based on systematic breakdown of psychological defenses through mental and physi- cal coercion, through isolation, over time13


. Kaplan and Saddock (ibid) did or disproved, rendering it


not extend the brainwashing analogy to children of divorce nor to children who have been neglected or abused.


Legal Consideration of PAS In all custody cases, the court’s task


is to make a decision that is “in the best interests of the child.” Montgomery County v. Sanders, 38 Md. App. 406, 381 A.2d 1154(1978). Among the many fac- tors set forth in Sanders for the court to consider is “the potentiality of maintain- ing natural family relations.” No Maryland case has either held or


rejected PAS as a recognizable psychiat- ric disorder. There is one reported case which includes the issue of PAS, Barton v. Hirschberg, 137 Md. App. 1, 767 A.2d 874, 2001 Md. App LEXIS 27 (2001). The


13


Kaplan and Sadock’s Synopsis of Psychia- try: behavioral sciences, clinical psychiatry, Kaplan HI, Sadock BJ, Grebb JA, 1994, Williams and Wilkins, Baltimore, MD.


21


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