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An Objective Measure of Splitting in Parental Alienation: The Parental Acceptance-Rejection Questionnaire


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Both clinicians and forensic practitioners should distinguish parental alienation (rejection of a parent without legitimate justification) from other reasons for contact refusal. Alienated children-who were not abused-often engage in splitting and lack ambivalence with respect to the rejected parent; children who were maltreated usually perceive the abusive parent in an ambivalent manner. The purpose of this study was to assess the usefulness of the Parental Acceptance-Rejection Questionnaire (PARQ) in identifying and quantifying the degree of splitting, which may assist in diagnosing parental alienation. Results showed that severely alienated children engaged in a high level of splitting, by perceiving the preferred parent in extremely positive terms and the rejected parent in extremely negative terms. Splitting was not manifested by the children in other family groups. The PARQ may be useful for both clinicians and forensic practitioners in evaluating children of divorced parents when there is a concern about the possible diagnosis of parental alienation.
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William Bernet,
M.D.; Nilgun Gregory,
Ph.D.; Kathleen M. Reay,
Ph.D.; and Ronald P. Rohner,
An Objective Measure of Splitting in Parental
Alienation: The Parental AcceptanceRejection
ABSTRACT: Both clinicians and forensic practitioners should distinguish parental alienation (rejection of a parent without legitimate justifi-
cation) from other reasons for contact refusal. Alienated childrenwho were not abusedoften engage in splitting and lack ambivalence with
respect to the rejected parent; children who were maltreated usually perceive the abusive parent in an ambivalent manner. The purpose of this
study was to assess the usefulness of the Parental AcceptanceRejection Questionnaire (PARQ) in identifying and quantifying the degree of
splitting, which may assist in diagnosing parental alienation. Results showed that severely alienated children engaged in a high level of split-
ting, by perceiving the preferred parent in extremely positive terms and the rejected parent in extremely negative terms. Splitting was not mani-
fested by the children in other family groups. The PARQ may be useful for both clinicians and forensic practitioners in evaluating children of
divorced parents when there is a concern about the possible diagnosis of parental alienation.
KEYWORDS: forensic science, child psychiatry, children of divorce, splitting, parental alienation, parental acceptancerejection questionnaire
Parental alienation is a mental condition in which children
usually children whose parents are engaged in a high-conflict sep-
aration or divorceally strongly with one parent (the preferred or
alienating parent) and reject a relationship with the other parent
(the rejected or target parent) without legitimate justification. In
contrast, justified estrangement refers to a childs rejection of a
parent for good reason, such as a history of abuse or neglect. In
both clinical and forensic evaluations, it is important to distinguish
alienation from justified estrangement and other causes of contact
refusal (1,2). The purpose of this study was to assess the useful-
ness of the Parental AcceptanceRejection Questionnaire (PARQ)
in identifying and quantifying the degree of splitting, which may
assist in distinguishing alienated from nonalienated children.
Splitting in Parental Alienation
Divorce is an important event having many psychological,
social, and legal implications. High-conflict divorce leads to
more significant struggles for children (3). Parental alienation,
which occurs primarily in children of separated and divorced
parents, has been described in the literature of mental health and
legal professionals in at least 35 countries on six continents (4).
The criteria for identifying parental alienation were originally
formulated by Gardner (5; Table 1). Although Gardner referred
to this condition as parental alienation syndrome,most con-
temporary authors simply use the term parental alienation.
Regarding diagnosis, parental alienation may be identified using
DSM-5 terminology: child affected by parental relationship dis-
tress,”“parent-child relational problem,and child psychologi-
cal abuse(68). Parental alienation is a complex family
dynamic that involves mental mechanisms in the affected child,
alienating behaviors of the preferred parent, reactions of the
rejected parent, and sociocultural phenomena (9,10). This study
is not a treatise on the broad topic of parental alienation, but
simply addresses a particular aspect of the mental state of an
alienated child, that is, splitting or lack of ambivalence.
Of the eight criteria that are commonly accepted for the diag-
nosis of parental alienation, lack of ambivalence is a symptom
that may be measured quantitatively. It is normal for interper-
sonal relationships to feature ambivalence. While young children
typically have an idealized view of their parents, older children
and adolescents usually perceive each parent as having both
strong points and weak points. It is unusual for an older child or
adolescent to perceive a parent in an all-or-none fashion, that is,
totally good or totally bad. However, children who experience
severe parental alienation almost always manifest splitting, such
that they idealize the alienating parent and devalue the target
parent. This aspect of parental alienation is not subtle: A boy
who was alienated from his father said, My mother is my
angel!My father is a devil!The same metaphor was used by
Akhtar and Byrne (11) in their review of the concept of splitting:
Vanderbilt University School of Medicine, 1313 21st Ave. South, 209
Oxford House, Nashville, TN 37232.
Vanderbilt Kennedy Center, 110 Magnolia Circle, Nashville, TN 37203.
Final International University, Toroslar Caddesi 6, Girne, Cyprus.
International Institute for Parental Alienation Studies, Kelowna, BC,
University of Connecticut, Department of Human Development and
Family Studies, Unit 1058, Storrs, CT 06269-1058.
*Presented at the International Conference on Shared Parenting Meeting,
May 30, 2017, in Boston, MA.
Dr. Nilgun Gregory received support from the Turkish Scientific and
Technological Research Council (T
ITAK); Dr. Kathleen Reay was the
founder and clinical director of the Family Reflections Reunification Pro-
gram; and Dr. Ronald Rohner is a partner in Rohner Research Publications,
which publishes the Parental AcceptanceRejection Questionnaire.
Received 17 May 2017; and in revised form 21 June 2017; accepted 21
July 2017.
1©2017 American Academy of Forensic Sciences
J Forensic Sci,2017
doi: 10.1111/1556-4029.13625
Available online at:
To the individual using extensive splitting, the world seems
populated by devils and angels but devoid of truly human fig-
ures(p. 1014) (11). Parental alienation occurs along a contin-
uum and typically progresses from mild to moderate to a severe
level of alienation. While splitting appears to be a common fea-
ture of severe parental alienation, it is not known how frequently
it occurs in mild and moderate levels of alienation.
The term splittinghas enjoyed multiple definitions and
applications in the history of psychology, psychiatry, and psy-
choanalysis. For Breuer and Freud (12), splitting of conscious-
nessinvolved alternating states of consciousness in hysterical
patients and was thus closely related to dissociation. In his stud-
ies of psychosis, Bleuler (13) introduced the term schizophrenia
or splitting of the mind.He used splittingto describe loose
associations and a fragmentation of the thinking processes(p.
350) (13). Klein (14) explained that children employed splitting
as a defensive maneuver to separate good from bad experiences,
perceptions, and emotions. Kernberg (15) and many others (e.g.,
16) emphasized how splitting or black-or-white thinking, lacking
ambivalence, is a feature of some mental disorders, especially
borderline personality disorder. Vaillant (17) classified splitting
as a pathological, primitive defense mechanism in which the
defended individual segregates experiences into all-good and all-
bad categories, with no room for ambiguity and ambivalence. In
the current research, we consider splitting to be a maladaptive
mental mechanism by which children protect themselves from
the uncomfortable feelings of cognitive dissonance, that is, from
anxiety caused by ongoing parental conflict. When there is con-
tinual warfare between the mother and father, children often find
it difficult to maintain affection for both parents at the same
time. They typically resolve the dissonance by the mechanism of
splitting, that is, by gravitating to an enmeshed relationship with
one parent and strongly rejecting the other parent.
It is essential to recognize that in parental alienation, the
childs rejection of the target parent is far out of proportion to
anything that parent has done to justify the rejection. Parental
alienation is maladaptive in the sense that the child has a false
belief that the rejected parent is evil, dangerous, or not worthy
of love. If a parent were truly abusive or severely neglectful, the
childs rejection of that parent would not constitute parental
alienation. Rather, it would be called realistic or justified
estrangement (2). Whereas alienated children perceive the
rejected parent as evil, most abused or neglected children still
perceive the abusive parent in an ambivalent manner. In her
classic book 50 years ago, Koppitz (18) said, It is sometimes
amazing to observe childrens loyalty to parents who are actually
rejecting and neglectful(p. 128) (18). More recently, Baker and
Schneiderman (19)who have extensively studied maltreated
childrensaid, The feeling of rejection experienced by [abused]
children resulted in a heightened desire for that parents love
and approval(p. 93) (19).
Several authors have said that the use of the defense mecha-
nism of splitting distinguishes alienated children. For example,
Lee and Olesen (20) said that the alienated child manifests lack
of ambivalence(p. 284) (20). Also, Ellis (21) said that one of
the features of parental alienation is the mechanism of splitting
to reduce ambiguity(p. 60) (21). Most recently, Jaffe, Thakkar,
and Piron (22) published qualitative research regarding denial
of ambivalence as a hallmark of parental alienation.They said,
The expressed lack of ambivalence as manifested by the alien-
ated child serves as an observable defining characteristic of the
presence of parental alienation(p. 1) (22). The research
reported here presents a quantitative method to identify the men-
tal mechanism of splitting in alienated children, which has been
described qualitatively so many times.
Objective Measures of Splitting
There have been previous attempts to measure splitting in
adults. Based on the writings of Kohut (23) and Kernberg (24),
Gerson (25) developed a 14-item questionnaire to measure
defensive splitting. At about the same time, Bond, Gardiner,
Christian, and Sigel (26) developed the Defense Style Question-
naire, a 67-item instrument, which was intended to measure vari-
ous defense mechanisms. Later, Gould, Prentice, and Ainslie
(27) constructed the Splitting Index, a 24-item questionnaire
intended to be a convenient instrument for empirical investiga-
tions of psychoanalytic object-relations theories of splitting as
well as of the borderline and narcissistic personality disorders
(p. 416) (27). The Splitting Index, intended for use with adults
in clinical settings, had good correlations with measures of bor-
derline personality disorder and narcissistic personality disorder.
Bricklin (28) developed the Bricklin Perceptual Scales (BPS)
specifically for use in child custody evaluations. The BPS con-
sists of 64 questions, which pertain to the childs perception of
the mother (32 questions) and the childs perception of the father
(32 questions). Although Bricklin did not use the term split-
tingin his discussion of that instrument, that appears to be what
he was measuring. Bricklin said that alienated children had a
mind-made-up (MMU) configuration, which occurred as part of
a not-based-on-actual-interaction (NBOAI) scenario. Bricklin
found that MMU children rated the preferred parent extremely
or abnormally high (i.e., favorably) and the rejected parent extre-
mely or abnormally low (i.e., unfavorably) on the BPS (p. 108)
The Parental AcceptanceRejection Questionnaire
In developing this research project, it seemed likely that the
Parental AcceptanceRejection Questionnaire (PARQ) would
help distinguish alienated children (who lack ambivalence and
engage in splitting) from nonalienated children (who were
expected to manifest ambivalence toward both parents). The
PARQa 60-item questionnaire that children complete regard-
ing their mothers and fatherswas not developed specifically
for the evaluation of children of divorced parents, although it
has been used in child custody evaluations (29). The measure
was derived from interpersonal acceptancerejection theory
(IPARTheory), an evidence-based theory that addresses the
TABLE 1–– Criteria for the diagnosis of parental alienation (5).
Campaign of denigration against the target parent.
Frivolous rationalizations for the childs criticism of the
target parent.
Lack of ambivalence.
Independent-thinker phenomenon.
Reflexive support of the alienating parent against the target
Absence of guilt over exploitation and mistreatment of the
target parent.
Borrowed scenarios.
Spread of the childs animosity toward the target parents
extended family.
implications of parental acceptance and rejection for individuals
personality and psychological adjustment (30,31).
The authors developed hypotheses that the PARQ would accu-
rately distinguish alienated children from nonalienated children
in the following manner. (1) We predicted nonalienated children
would manifest ambivalence toward both parents, even parents
who had been neglectful: The mean PARQ score for the parent
who has been neglectful will be high (i.e., somewhat rejecting),
but not extremely high. That prediction was based on research
that maltreated children often maintain ambivalence toward
neglectful and abusive parents. (2) We predicted that severely
alienated children would manifest splitting: The mean PARQ
score for the preferred parent will be very low (i.e., perceived
acceptance), and the mean PARQ score for the alienated or tar-
get parent will be very high (i.e., perceived rejection). That pre-
diction was based on the common understanding that severely
alienated children lack ambivalence with regard to their parents;
that is, they perceive the preferred parent as extremely good and
the alienated parent as extremely bad. (3) We predicted that the
pattern of PARQ scores for the neglected children would differ
significantly from the pattern of PARQ scores for the alienated
children. That prediction was based on the observation that
alienated children intensely reject the less preferred parent,
whereas neglected children still hope that the parent will treat
them better and love them. Review and approval of this study
was obtained from the Vanderbilt University Institutional
Review Board.
Case Summary
The following clinical vignette illustrates parental alienation in
a male adolescent, whose scores on the PARQ: Mother and
PARQ: Father exhibit splitting as described in this article.
Brad(a participant in this research) experienced a severe level
of parental alienation; Brads clinical symptoms were expressed
in his scores on the PARQ.
The parents of Brad, a 16-year-old male, were in a protracted
custody dispute for nearly three years. About a week after the
parents separated, the father received a text message from Brad
who accused him of fondling the boys genitals at age 2 during
a family camping trip. Brad claimed he hated his father and
refused to ever see him again. The father recalled his son had a
urinary tract infection at age 2 and was prescribed an ointment
by the family physician just prior to a family vacation. Both par-
ents responsibly and individually administered the ointment dur-
ing diaper changes in a tent. The mother and son had never
made similar claims against him in the past. Two days after
receiving the text message, the father arrived at the mothers
home to pick up Brad; the mother refused to let the boy leave.
The father returned the following day in another attempt to see
Brad; the mother opened the front door and insisted that Brad
did not want to see the father. Then, the mother phoned 911.
She alleged to the police that the father deliberately pushed her
to the ground. Although the police officers found the mothers
statements to be inconsistent, they arrested the father and
released him when he agreed to not communicate with the
mother or go to her address.
Eventually, the family court ordered a child custody evalua-
tion by an experienced psychologist. During interviews with the
evaluator, Brad claimed he remembered his fathers touching his
genitals at age 2. Brad provided other unfounded, vague, and fri-
volous reasons for refusing contact with his father. When the
evaluator visited the mothers home, he noticed a picture frame
in Brads bedroom, which was turned around and taped to the
wall so that the front was not visible. Brad showed the evaluator
the reversed photograph of his father and said it was turned
around because I hate him. He never loved me and we never
had any fun times together.The evaluator determined that there
had been a good baseline relationship between the father and
son, but an abrupt change for the worse occurred immediately
after the parents separated. The evaluator opined this was a case
of severe parental alienation. The court made the same finding
and ordered the entire family to participate in the Family Reflec-
tions Reunification Program. At the outset of the intensive reuni-
fication treatment, Brad completed the PARQ, which indicated
an unrealistically positive view of his mother (PARQ:
Mother =63) and an unrealistically negative view of his father
(PARQ: Father =234). (The lowest possible score on the PARQ
is 60; the highest possible score is 240.)
In this article, childrenusually refers to children and ado-
lescents.Although some of the children recruited for this study
were sibling groups, we randomly selected one child from each
family to participate in the study. Participants (total N=116, M
age =13.1 years, SD =2.64, range =9 through 17 years in
each of the four groups) were recruited for the following family
Children from intact families (n=35): a control group, that
is, children who lived together with both parents in one house-
Children of divorced parents (n=20): a second control group,
that is, children whose parents were divorced or separated, but
the children continued to see both parents on a regular basis.
Neglected children (n=16): children whose parents were
divorced or separated, but the children did not see both parents
on a regular basis. In this research, all the neglected children
lived with their mothers and rarely or never saw their fathers.
The mothers uniformly described the fathers as being unreliable
in contacting their children, uninterested in having a relationship
with their children, and neglectful by abandoning the family. It
was a coincidence of sampling that all of the children in this
group were neglected by their fathers. That was fortunate
because it became possible to compare children neglected by
their fathers with children alienated from their fathers. Although
we know the children in this group were neglected by their
fathers, we do not know whether they were estranged from their
fathers. We do not know whether they met the definition of
estranged introduced by Kelly and Johnston (2), that is, children
who wish to severely limit contact with [a] deficient or fright-
ening parent(p. 254) (2). Thus, in this study we are not able to
directly compare alienated and estranged children, but we do
compare alienated and neglected children.
Children in the first three family types (intact, divorced, and
neglected) were recruited through ResearchMatch, a national
health volunteer registry that was created by several academic
institutions and supported by the U.S. National Institutes of
Health as part of the Clinical Translational Science Award
(CTSA) program. ResearchMatch has a large population of vol-
unteers who have consented to be contacted by researchers about
studies for which they may be eligible. Children in these family
types were recruited through ResearchMatch between April and
December 2015. Although they came from various parts of the
U.S.A., they were homogeneous in their willingness to partici-
pate in medical research.
Alienated children (n=45): children whose parents were
divorced or separated, and the children strongly rejected a rela-
tionship with one of their parents. Of the 45 youth in the alien-
ated families, 24 were alienated from their fathers and 21 were
alienated from their mother. Thus, the alienated families were
divided into the alienated-father families and the alienated-
mother families.
Children in the alienated families were all recruited from the
Family Reflections Reunification Program, a program in British
Columbia, Canada, which specialized in the treatment of paren-
tal alienation (32). These youth were enrolled in the Family
Reflections Reunification Program consecutively between April
2013 and October 2015. The families of the alienated children
lived in about 14 cities in the U.S.A. and Canada. In all cases,
experienced mental health professionals determined that the chil-
drens rejection of one parent was without justification. All the
evaluators had doctoral degrees in clinical psychology (Ph.D. or
Psy.D.) and were licensed to practice psychology in their respec-
tive jurisdictions. The evaluators consistently noted in their writ-
ten reports two important features of parental alienation: The
childs refusal to have contact with the target parent was unjusti-
fied; and the childs negative thoughts and feelings toward the
target parent were disproportionate to their actual experiences
with that parent. The evaluators concluded that the children
were severely alienated. Their cases were heard in family courts
in various locations in the U.S.A. and Canada, which also con-
cluded the children were severely alienated. In all cases, the
courts ordered the families to participate in the Family Reflec-
tions Reunification Program. Although they had initially been
evaluated by mental health professionals in several locations in
Canada and the U.S.A.and they had been ordered into treat-
ment by family courts in several locations in Canada and the
U.S.A.the alienated families were homogeneous in that the
staff of the same specialized treatment program determined with
a high level of confidence that all the youth in that group exhib-
ited a severe level of parental alienation. Table 2 provides infor-
mation about the characteristics of the children and their
The Parental AcceptanceRejection Questionnaire (PARQ)
provides an objective, quantitative measure of childrens percep-
tions of parental (maternal and paternal) acceptingrejecting
behaviors (33). Children respond to 60 statements regarding each
parentfor example, My father says nice things about me
by choosing Almost Always True, Sometimes True, Rarely True,
or Almost Never True. The responses are scored 1 through 4,
with the lower values reflecting a more positive perception of
that parent, and the higher values reflecting a more negative
perception of that parent. (Some of the responses are scored in
reverse, so that the positive perceptions are always the lower
value.) Thus, children who gave their fathers the most positive
assessment on all 60 statements would have a PARQ: Father
score of 60, whereas children who gave their fathers the most
negative assessment on all 60 statements would have a PARQ:
Father score of 240.
Rohner (33) found that in the U.S.A., PARQ scores... typ-
ically fall between 90 and 110, indicating the experience of
substantial loving acceptance(p. 49) (33). He also found that
7% to 10% of American youths and adults tend to respond at
150 or higher, revealing the presence of very serious parental
rejection(p. 49) (33). The PARQ has been used in more than
550 studies in over 40 languages with several hundred thou-
sand respondents in about 60 countries. Extensive evidence
reported in Rohner (33) and Khaleque and Rohner (34) shows
that the PARQ is a reliable and valid measure for use in
national and international research. This conclusion is sup-
ported in the present study, where coefficient alphas are high
for both the PARQ: Mother and PARQ: Father respectively in
all five groups: intact families, .83, .85; children of divorced
parents, .85, .83; children with neglectful fathers, .82, .88;
alienated-father families, .94, .70; and alienated-mother
families, .96, .89.
Respondents in the intact families, children of divorced par-
ents, and neglected children participated in this research online
through the Research Electronic Data Capture (REDCap) pro-
gram, a secure web application for building and managing online
surveys and databases. Research personnel obtained informed
consent from parents and assent from children. After confirming
that the child was located in a room alone without any parent
present, the child completed the child version of the PARQ:
Father and the child version of the PARQ: Mother.
Respondents in the alienated families completed the PARQ
shortly after arrival at the alienation-specific treatment program.
These youth had already been determined by experienced mental
health professionals and a family court to be manifesting severe
parental alienation. These youth also completed the PARQ:
Father and PARQ: Mother. They were administered the child
version of the PARQ with regard to the preferred parent and the
adult version of the PARQ with regard to the rejected or alien-
ated parent. That adjustment in the research protocol was made
because the Child PARQ is written in the present tense (My
father says nice things about me.), whereas the Adult PARQ is
written in the past tense (My father said nice things about
me.) As the children in the alienated families had typically not
seen the rejected parent for a long timeusually more than a
yearit was appropriate to use a questionnaire that was
expressed in the past tense.
TABLE 2–– Characteristics of participants and their parents.
Family Type Intact Divorced Neglected Alienated-Father Alienated-Mother
Source of participants RM RM RM FR FR
No. of participants 35 20 16 24 21
Gender (male:female) 22:13 11:9 8:8 9:15 10:11
Mean age (SD) of children 12.5 (2.86) 13.1 (3.07) 13.3 (2.98) 13.9 (2.07) 13.3 (2.01)
Preferred parent (mother:father) 16:0 24:0 0:21
RM, ResearchMatch; FR, Family Reflections Reunification Program.
An initial analysis of age and gender differences in partici-
pantsresponses to the PARQ: Mother and PARQ: Father for
each of the five family types showed thatwith one exception
neither age nor gender for either males or females was signifi-
cantly associated with participantsreports of maternal or pater-
nal acceptancerejection. Data supporting this conclusion are
displayed in Tables 3 and 4. The sole exception to this conclu-
sion pertains to participantsreports of both maternal and pater-
nal acceptancerejection in alienated-father families. There,
Table 3 shows that the older the youths were, the more loving
(accepting) they reported their mothers to be and the more
rejecting they reported their fathers to be. Because there were no
gender differences in participantsreports of parental accep-
tancerejection in any of the five family typesand because
there was only one age difference in all of these relationsall
further analyses were pooled across age and gender within each
family type.
Intact Families
The children from intact families had PARQ scores that ran-
ged from 73 through 117. The PARQ: Father (M=93.26,
SD =10.04, 95% CI [89.81, 96.71]) and PARQ: Mother
(M=93.14, SD =11.70, 95% CI [89.12, 97.16]) scores were
almost exactly equal. This indicates that both parents in the
intact families fell into the realistic warm and loving (accepting)
range, which reflects the childrens perception of loving, nurtur-
ing parents. These scores are consistent with other studies of
children in the U.S.A. (33). Campo and Rohner (35), for exam-
ple, found that a control group of adolescents and young adults
in the U.S.A. had mean PARQ: Father scores of 93.9
(SD =26.4) and mean PARQ: Mother scores of 95.0
(SD =14.0). Veneziano (36) found that African American and
European American children and adolescents had mean paternal
PARQ scores of 97 (SD =20.4) and the mean maternal PARQ
scores of 98.2 (SD =28.4).
Children of Divorced Parents
Children of divorced parentswho continued to see both par-
ents on a regular basishad PARQ scores that ranged from 102
through 134. The PARQ: Father (M=118.85, SD =8.05, 95%
CI [115.08, 122.62]) and PARQ: Mother (M=115.20,
SD =9.08, 95% CI [110.95, 119.45]) scores were also very
close to each other. In the divorced families, both parents were
perceived to be fairly loving (accepting), but the children under-
standably perceived both parents to be somewhat less loving
than did children in intact families. That difference is consistent
with a study by
Ongider (37) in Turkey, who found that children
of low-conflict-married parents had more positive perceptions of
their parents than children of low-conflict-divorced parents.
Neglected Children
The children of divorced parents who did not see both parents
on a regular basis had a distinctly different pattern of PARQ
scores. For these children, the PARQ: Mother scores ranged
from 93 through 111 (M=99.06, SD =5.71, 95% CI [96.02,
102.10]) and the PARQ: Father scores ranged from 124 through
170 (M=144.38, SD =13.32, 95% CI [137.28, 151.47]). As
noted earlier, all children in this group lived with their mothers;
the children saw their fathers rarely or never. The fathers were
uniformly described as neglectful. Thus, it is understandable that
the children perceived their fathers to be somewhat rejecting,
whereas they perceived their mothers to be warm and loving (ac-
cepting) in a realistic sense. The childrens perception of their
fathers is negative, but not extremely so. The data suggest that
these children still have some positive feelings (thus, ambiva-
lence) toward their neglectful fathers. Therefore, the first hypoth-
esis was confirmed.
Alienated Children
PARQ scores for alienated children were dramatically differ-
ent from those of the other three family groups. As the children
were alienated from their father (n=24) or from their mother
(n=21), it was necessary to separate alienated families into
alienated-father families and alienated-mother families. The pre-
ferred parent in both of these groups had extremely (unrealisti-
cally) low PARQ scores, whereas the alienated parent had
extremely (unrealistically) high PARQ scores.
More specifically, for the alienated-father families, PARQ:
Mother scores ranged from 60 through 102 (M=64.67,
SD =8.43, 95% CI [61.25, 69.32]) and PARQ: Father scores
ranged from 209 through 240 (M=231.88, SD =6.43, 95% CI
[228.11, 233.99]). For the alienated-mother families, PARQ:
Mother scores ranged from 125 through 240 (Mean =212.52,
SD =26.68, 95% CI [200.38, 224.67]) and the PARQ: Father
scores range from 60 through 103 (Mean =67.86, SD =8.92,
95% CI [63.80, 71.92]). These scores reveal that alienated chil-
dren typically have extremely positive perceptions of the pre-
ferred parent, who is called the alienating parent in cases of
severe parental alienation. On the other hand, alienated children
typically have extremely negative perceptions of the rejected par-
ent, who is called the alienated or target parent in such cases.
These data indicate that alienated children manifest the psycho-
logical mechanism of splitting, so the second hypothesis was
confirmed. Figure 1 displays the PARQ: Mother and PARQ:
Father scores for the five family types.
Of great interest, we should note that the pattern of PARQ
scores effectively distinguished alienated children from neglected
children. As shown in Table 5, the children of alienated fathers
perceived their fathers significantly more negatively than
neglected children perceived their fathers. Likewise, children of
alienated fathers perceived their mothers significantly more posi-
tively than neglected children perceived their mothers. Thus, we
conclude that the third hypothesis was confirmed. The effect size
(Cohensd=8.37 in comparing the PARQ: Father of alienated
children with that of neglected children) was extremely high.
The very high incidence of severe rejection, which was pre-
dicted, had not been observed in previous research with the
TABLE 3–– Correlation between participantsage and participants
responses to the PARQ: Father and PARQ: Mother, by family type.
Family Type n
PARQ: Father PARQ: Mother
Intact 35 0.16 0.24
Divorced 20 0.09 0.30
Neglected 16 0.45 0.18
Alienated-father 24 0.55** 0.54**
Alienated-mother 21 0.06 0.04
PARQ. However, Bricklin observed the same phenomenon when
children were tested with the Bricklin Perceptual Scales. He said
that in cases of parental alienation, most of the childs
responses will be extremely positive for the alienating parent
and negative for the target parent(p. 108) (28).
The premise of this research was that it should be possible
to compare quantitatively alienated childrens perceptions of
their parents (which are likely to be strongly positive and
strongly negative) with nonalienated childrens perceptions of
their parents (which are likely to be ambivalent). We expected
that the PARQ would distinguish alienated children, who had
not been maltreated, from maltreated children who had been
neglected by their fathers. The fact that these predictions
were confirmed in this research indicates that the PARQ:
Father and the PARQ: Mother may be useful measures for the
clinical and forensic evaluation of children who may be
This research supports the reality of parental alienation, in that
the severely alienated children consistently manifested a distinct
maladaptive mental mechanism, an intense level of splitting,
which had previously been described in descriptive, qualitative
research for many years (5,2022). Also, the high level of split-
ting was observed in alienated children, but was not observed in
the other family groups. This support for the reality of parental
alienation is important because some critics have said that paren-
tal alienation does not exist (38,39, pp. 52-53).
Child custody evaluations are an important event for many
families who are experiencing divorce. It is very important for
custody evaluators to understand childrens perceptions of their
parents, and to identify and correctly diagnose parental alien-
ation. Evidence reported here shows that the PARQ may assist
custody evaluators as well as clinicians in distinguishing neglect-
ful parenting such as abandonment and parental alienation.
Future research may also show that the PARQ assists forensic
and clinical evaluators in distinguishing justified estrangement
(contact refusal due to a legitimate fear) and alienation (contact
refusal driven by a false belief). That distinction is important
because the recommendation in cases of justified estrangement
(such as limited contact with the rejected parent) may be the
TABLE 4–– Gender differences in malesversus femalesresponses to PARQ: Father and PARQ: Mother, by family type.
Family Type
PARQ: Father PARQ: Mother
Males Females
tdf p
Males Females
Intact 93.32 9.24 93.15 11.68 0.04 20.89 ns 91.14 11.14 96.54 12.37 1.30 23.68 ns
Divorced 120.36 6.62 117.00 9.61 0.89 13.77 ns 116.45 10.12 113.67 7.94 0.69 17.98 ns
Neglected 145.25 14.24 143.50 13.25 0.26 13.93 ns 96.75 3.88 101.38 6.52 1.72 11.41 ns
Alienated-father 232.22 4.18 231.67 7.60 0.23 21.92 ns 62.78 3.11 65.80 10.37 1.05 17.82 ns
Alienated-mother 64.60 3.34 70.82 11.36 1.74 11.87 ns 223.00 16.34 203.00 31.22 1.86 15.38 ns
ns, not significant.
FIG. 1–– Relation between perceived parental acceptancerejection and family type. Lowest possible score on PARQ =60 (very positive perception of par-
ent); highest possible score on PARQ =240 (very negative perception of parent). Error bars: 95% CI.
TABLE 5–– Mean PARQ: Father and PARQ: Mother differences between
children of alienated fathers and children of neglectful fathers.
PARQ: Father PARQ: Mother
MSD t(38) MSD t(38)
Children of
24 231.88 6.43
64.67 8.43
Children of
16 144.38 13.32 99.06 5.71
opposite of the recommendation in cases of alienation (such as
limited contact with the preferred parent).
Clinicians as well as forensic practitioners have found that
there are important counterintuitive features to parental alien-
ation (40). Perhaps the most consistently observed paradoxical
aspect of parental alienation has been the observation that alien-
ated children, who were not maltreated by the rejected parent,
have a much more negative opinion of that parent than do chil-
dren who have been maltreated by the rejected parent. Some
mental health evaluators wrongly conclude that the childs insis-
tence on the malevolence of the rejected parent is evidence for
actual abuse by that parent. In fact, the childs extreme insis-
tence on the malevolence of the rejected parent may be evidence
of parental alienation, not of abuse. In cases involving mild or
moderate maltreatment, children typically remain ambivalent
toward abusive parents because they hope those parents will
change their ways and become consistently loving caregivers
There are cases, of course, of chronic, severe child abuse in
which maltreated children totally and rightfully want the abusive
parent out of their lives forever. We realize that both groups of
childrenseverely alienated and severely abusedmight rate
one parent in an extremely negative manner on the PARQ. In
those cases, the distinction between alienation and abuse would
not be made with the PARQ, but the diagnosis would be estab-
lished by a detailed family history. Because of the obvious
severity of the abuse, cases of severe child maltreatment are usu-
ally identified by child protection agencies and are not addressed
in child custody evaluations.
With regard to limitations, we acknowledge that this research
is limited by the fact that the 16 children with neglectful fathers
were clearly maltreated (neglected, abandoned, psychologically
abused), but we do not know whether they were estranged in the
way the term is now used (2). For example, we do not know
whether the children of the neglectful fathers rejected a relation-
ship with those fathers. Thus, we can say that the PARQ distin-
guished alienated children from other family groups (children of
intact parents, children of divorced parents, and neglected chil-
dren), but we cannot say that the PARQ distinguished alienated
and estranged children. Also, it is possible that the very high
PARQ scores for the alienated parents were related to the setting
in which the test was administered; data were gathered from the
alienated children during admission to involuntary, court-ordered
treatment, which the children presumably blamed on the rejected
parent who brought the matter to court. Another possibility is
that the high PARQ scores for the alienated parents were not
related to parental alienation, but were caused by the childs lack
of contact with that parent. Thus, although we believe that the
extreme level of splitting caused or contributed to the childs
refusal to spend time with the alienated parent, it could have
been the other way around; that is, the lack of time with the
alienated parent led to a very high PARQ score for that parent.
It will be important in future research to compare directly the
PARQ scores of alienated and estranged children, as well as
children who have experienced a hybrid blend of estrangement
and alienation together. It will be useful in the future to learn
how children who have experienced mild, moderate, and severe
maltreatment respond to the PARQ for the abusive parents and
for the nonabusive parents. Also, it will be useful to learn how
children who have experienced mild, moderate, and severe levels
of parental alienation respond to the PARQ for the preferred par-
ent and for the rejected parent. Typical definitions of those terms
are: mild parental alienation means that the child resists contact
with the target parent but enjoys the relationship with that parent
once parenting time is underway; moderate parental alienation
means that the child strongly resists contact and is persistently
oppositional during parenting time with the target parent; severe
parental alienation means that the child persistently and ada-
mantly refuses contact and may hide or run away to avoid being
with the target parent (9, p. 23).
Of course, the PARQ should not be used in isolation to deter-
mine whether a child is alienated. The measurelike most psy-
chological testsshould be part of a comprehensive psychiatric
and/or psychological assessment of the family, including multi-
ple interviews, meetings with collateral informants, review of
records, and teamwork with other professionals. However, we
conclude that both clinical and forensic practitioners should con-
sider using the PARQ as one component of a comprehensive
evaluation when they are concerned about the possible diagnosis
of parental alienation.
The authors appreciate the helpful assistance of Amy J. L.
Baker, Ph.D., Bradley Freeman, M.D., James S. Walker, Ph.D.,
Sumbleen Ali, M.Phil., and James Lopez in developing this
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William Bernet, M.D.
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... ao objetivo dos estudos selecionados, é possível verificar que apenas seis deles(Bernet et al., 2018;Carvalho et al., 2017;Laughrea, 2002;Rowlands, 2019;Zicavo et al., 2016) apresentaram como objetivo desenvolver instrumentos de medida para avaliação da alienação parental. Quanto ao método, verificou-se que todos os estudos apresentaram abordagem quantitativa e corte transversal. ...
... Quanto ao método, verificou-se que todos os estudos apresentaram abordagem quantitativa e corte transversal. Em relação ao delineamento, apenas um estudo referiu-se a análise de documentos (autos processuais).No que que diz respeito aos participantes, apenas duas pesquisas foram realizadas com crianças e adolescentes(Bernet et al., 2018;Zicavo et al., 2016), duas com profissionais que atuavam no sistema de justiça (Gomide et al., 2016; Saldaña et al., 2013) e duas com pais alvos de alienação parental. Para mensurar alienação parental, o instrumento mais utilizado nos estudos selecionados foi o Baker Strategy Questionnaire (BSQ) (n= 7). ...
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... This process of thinking works for the alienating because they deem conflicting behaviours performed by the targeted parent or grandparent as negative, but the same behaviour performed by themselves or the alienating parent's allies as acceptable. Compartmentalised thinking is akin to psychological splitting (e.g., Bernet, Gregory, Reay & Rohner, 2018) and is referred to by alienated grandparents in the current study. Research suggests that this all-or-nothing thinking provides a rationale for the alienating parent's control, whilst leaving no room for insight or change, thus reinforcing alienation of the targeted parent and grandparents (Clawar & Rivlin, 2013). ...
This study explored parental alienating behaviours experienced by grandparents with limited or no contact with their grandchildren. Twelve alienated grandparents participated in semi-structured interviews investigating their experience of alienation. The data were analysed using an inductive thematic analysis approach. Alienated grandparents reported being exposed to 13 parental alienating behaviours used by the alienating parent. These behaviours are consistent with those reported by targeted parents and adult alienated children in other studies. This study showed that parental alienating behaviours also affects grandparent-child relationships. Further research is needed to better understand the impact of parental alienation on grandparents and the wider family system.
... Interestingly, one son testified that he saw his father beating his mother while the other son denied his father ever was abusive. This kind of splitting in children is common in some abusive families or when one parent alienates a child against the other parent (Bernet et al., 2018). The laws in her state did not permit expert testimony that she was a battered woman who acted in self-defense, and she is still trying to get released from prison. ...
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... Quando há conflito contínuo entre os genitores, o filho, geralmente, tem dificuldade em manter afeto com ambos os pais ao mesmo tempo. Então, ele geralmente resolve essa dissonância pelo mecanismo de splitting, ou seja, mantém um relacionamento íntimo com um dos pais e rejeita fortemente o outro pai(Bernet, Gregory, Reay, & Rohner, 2017). ...
In this article a systematic literature review was conducted to find studies that assist in the identification of Parental Alienation and in the practice of professionals who act in expertise psychological evaluation in the Brazilian legal system. A search was performed without delimitation per year in seven electronic databases, where, after the exclusion stages, 14 articles composed this review. Data were grouped from indexing in the following categories: year of publication, publication by countries, by authors and by periodicals, articles methodology, name of the instruments, target audience and goals. We analyzed the possibility of using the instruments in the legal context and the use of additional tools in each research. Studies about the subject are recent, and more research must be developed, especially those of validation of these instruments for the Brazilian context.
... In an effort to help implement this task effectively, Bernet, Gregory, Reay, and Rohner (2018), and Bernet, Gregory, Rohner, and Reay (2020) developed a technique using the mother and father forms of the Adult PARQ to help distinguish parental alienation from parental estrangement and other forms of malparenting. In the Bernet et al. (2020) study, this technique distinguished with 99% accuracy severely alienated children from nonalienated children. ...
Interpersonal acceptance-rejection theory (IPARTheory) is an evidence-based theory of socialization and lifespan development. It is composed of three subtheories, each of which deals with a separate but interrelated set of issues. IPARTheory’s personality subtheory – which is the most highly developed component of the theory – deals primarily with the pancultural nature and effects of interpersonal acceptance and rejection. Coping subtheory explores the fact that some individuals are better able to cope with experiences of perceived rejection than are other individuals. Finally, IPARTheory’s sociocultural systems subtheory attempts to predict and explain major causes and sociocultural correlates of interpersonal acceptance-rejection worldwide. Empirical evidence overwhelmingly supports the theory’s major postulates and predictions, especially postulates and predictions in personality subtheory. Emerging evidence about the neurobiological and biochemical risks posed for the development, structure, and function of the human brain are beginning to help explain why these postulates and predictions are so consistently confirmed panculturally.
... Researchers have proposed several variables as contributing factors to parental alienation, including: the personality characteristics of family members, the nature of the parental relationship, the nature of the parent-child relationship, parents' links with their family of origin, and environmental and social factors (Birgden & Cucolo, 2011;Fidler et al., 2012;Gennari & Tamanza, 2017;Saini et al., 2016;Verrocchio et al., 2018). Studies have also shown that parents who are classified as alienating tend to implement primitive defense mechanisms, such as projection, denial, splitting, idealization, and devaluation (Bernet et al., 2018;Gordon et al., 2008); they also demonstrate maladaptive personality traits (e.g., histrionic, paranoid, borderline, and narcissistic traits) and higher levels of psychopathology (e.g., substance abuse, psychosis, and suicidal ideation), and they tend to respond to the parental separation with anger and hatred, rather than sadness or loss (Demby, 2009;Fidler & Bala, 2010;Johnston et al., 2005;Verrocchio et al., 2018). Preferred parents have also been found to be typically jealous, angry, emotionally vulnerable, and dependent on others (in some cases, even their children) for the consolidation of their self-esteem . ...
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The present study aimed at understanding the personality features of mothers and fathers engaged in parental alienation—a family dynamic in which one parent behaves in a way that foments a child’s unfounded emotional rejection of the other parent. The process is considered a complex form of child psychological maltreatment, with significant negative consequences. In cases of conflictual separation and divorce, parental alienation can be difficult—yet important—to identify. In this context, use of psychological assessment to understand parents’ personality characteristics may facilitate the early identification of parental alienation and related abuses. A comparative analysis of the Minnesota Multiphasic Personality Inventory-2 profiles of 41 couples engaged in parental alienation and 39 control couples (i.e., not involved in parental alienation) was used to assess the personality characteristics of mothers and fathers engaged in parental alienation. The results indicated that mothers who were classified as alienating presented a faking-good defensive profile, denied hostile and negative impulses, blamed others for their problems, and displayed excessive sensitivity. On the other side, fathers who were classified as targets of alienating behaviors were adapted to chronic depressive states, social isolation, and interpersonal conflict. The results suggest that the personality profile of parents involved in parental alienation may provide useful insight for custodial cases, prevent further abuse, and contribute to improving psychological and rehabilitative programs. Clinical and forensic implications are discussed.
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Artykuł jest analizą alienacji rodzicielskiej z perspektywy diagnozy psychologicznej umożliwiającej jej odróżnienie od reakcji dziecka na rodzica faktycznie krzywdzące-go. W pierwszej kolejności należy wskazać, że wywieranie na dziecko wpływu prowa-dzącego do alienacji jest formą emocjonalnej przemocy i powoduje skutki podobne do innych form jego krzywdzenia. Opiniowanie i wyciąganie wniosków wyłącznie na podstawie diagnozy dziecka nie jest wystarczające. Opierając się na współcze-snych modelach alienacji rodzicielskiej, proponujemy systemowe podejście do jej dia-gnozowania, w którym konieczne jest uwzględnienie psychologicznej charakterystyki funkcjonowania dziecka, cech funkcjonowania rodziców oraz interakcji między nimi, podłoża motywacyjnego towarzyszącego alienacji, a także relacji każdego z rodziców z dzieckiem. Artykuł kończą wskazówki mogące służyć diagnozie alienacji rodziciel-skiej i różnicowaniu tej sytuacji z innymi formami przemocy oraz sygnalizujące sytu-acje złożone, w których dziecko doświadcza wielu form krzywdzenia. Słowa kluczowe: alienacja rodzicielSka, przemoc, rodzina jako SyStem, diagnoza różnicowa
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Antecedentes: Son diversos las/os investigadoras/es que se han interesado por el fenómeno de la alienación parental. No obstante, esta compleja dinámica relacional no ha estado exenta de controversias. Objetivo: Realizar una revisión sistemática de las perspectivas y tendencias actuales del concepto de alienación parental, sus características y efectos en la población que experimentan estas circunstancias. Método: Se utilizó la metodología PRISMA-P para llevar a cabo una búsqueda bibliográfica exhaustiva de artículos publicados entre el año 2016 y junio de 2020 en revistas indexadas Scopus y/o WOS. Se contemplaron 95 estudios, de los cuales 11 fueron considerados para la revisión, de acuerdo con los criterios de inclusión y exclusión preestablecidos. Se identificó un amplio campo investigativo en el cual se circunscribe la alienación parental, como dinámica relacional. Resultados: Los 11 estudios seleccionados establecían relaciones entre la experiencia de alienación parental e indicadores de salud mental, tanto en niños, niñas, adolescentes, como adultos que experimentan o experimentaron estas dinámicas. Así también, se relacionó con maltrato psicológico. Conclusiones: La alienación parental es un fenómeno con una importante prevalencia en la población y se ha vinculado con un deterioro en la salud mental de las personas que la experimentan o la han experimentado.
The Turning Points for Families (TPFF) therapeutic intervention program for severely alienated children and their alienated parent was evaluated to determine whether it was safe, did not cause harm, and led to positive changes in the alienated parent-alienated child relationship. Court orders and video recordings of the 4-day intervention were reviewed for indications of improvements over the course of the intervention in relational communication, social support, and communal coping, which refers to the family members jointly “owning” a problem and proactively taking responsibility for it together. Improvements in the parent-child relationships were noted, and the TPFF helped to improve family member’s communal coping scores. Participation did not lead to negative changes on any measure. This preliminary evidence indicates that TPFF, similar to other therapeutic structural interventions, is a safe and effective treatment option for severely alienated children.
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Parental alienation is a construct which describes a campaign of disenfranchisement from children on the part of one parent against another, particularly during divorce. It has been at the forefront of child custody research aimed at explaining its short- and long-term effects on the children affected by it. During a time when tension between parents is at its highest and conflict regarding parenting responsibilities and parenting time arises, parents resort to parental alienation in an effort to control and hinder the emotional relationship the children would otherwise forge with the other parent. This paper is a review and integration of established ambivalence and parental alienation theory incorporating clinical examples. The clinical examples are cited from real interviews conducted by the authors from 2010 to 2016. The purpose and diagnostic utility of the examination of this subject matter is to exemplify the need for making a fine grain clinical analysis of ambivalence in order to most acc...
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Objective: A new condition, "child affected by parental relationship distress" (CAPRD), was introduced in the DSM-5. A relational problem, CAPRD is defined in the chapter of the DSM-5 under "Other Conditions That May Be a Focus of Clinical Attention." The purpose of this article is to explain the usefulness of this new terminology. Method: A brief review of the literature establishing that children are affected by parental relationship distress is presented. To elaborate on the clinical presentations of CAPRD, four common scenarios are described in more detail: children may react to parental intimate partner distress; to parental intimate partner violence; to acrimonious divorce; and to unfair disparagement of one parent by another. Reactions of the child may include the onset or exacerbation of psychological symptoms, somatic complaints, an internal loyalty conflict, and, in the extreme, parental alienation, leading to loss of a parent-child relationship. Results: Since the definition of CAPRD in the DSM-5 consists of only one sentence, the authors propose an expanded explanation, clarifying that children may develop behavioral, cognitive, affective, and physical symptoms when they experience varying degrees of parental relationship distress, that is, intimate partner distress and intimate partner violence, which are defined with more specificity and reliability in the DSM-5. Conclusion: CAPRD, like other relational problems, provides a way to define key relationship patterns that appear to lead to or exacerbate adverse mental health outcomes. It deserves the attention of clinicians who work with youth, as well as researchers assessing environmental inputs to common mental health problems.
Child Custody and Domestic Violence: A Call for Safety and Accountability focuses on the complexity of the challenges facing judges, lawyers, legislators, and mental health professionals in developing safe and effective strategies for resolving custody disputes. Jaffe, Lemon, and Poisson integrate the most recent clinical and legal issues in the field in considering the prevalence of divorce and domestic violence as well as the relevance of domestic violence in custody disputes. The authors outline the essential differences between custody disputes with and without allegations and findings of domestic violence, and the different analysis and distinct interventions by judges, policymakers, and mental health professionals necessary in domestic violence cases.