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Citation: Perrotta G (2021) Parental Alienation Syndrome (PAS): Definition, humanistic profiles and clinical hypothesis of absorption with “adaptation disorder”.
Clinical evidences. Open J Pediatr Child Health 6(1): 036-042. DOI: https://dx.doi.org/10.17352/ojpch.000035
https://dx.doi.org/10.17352/ojpchDOI:
2640-7612
ISSN:
MEDICAL GROUP
Abstract
Purpose: The present research aims to fi nd clinical evidence for the starting hypothesis: parental alienation is a form of psychological violence that is part of the
adjustment disorder fuelled by dysfunctional parental conduct.
Methods: Using the Perrotta Integrative Clinical Interview (PICI-1C, for children), a restricted and low sample of patients was selected (21 subjects), all aged between
4 and 10 years, with a clinically relevant behavioural manifestation (and a presumed “label” of parental alienation), with parents in the process of marital separation not yet
concluded and in a confl ictual or in any case diffi cult intra-familiar relational context. Anonymity was guaranteed to all.
Results: According to the PICI-1C, 100% (21/21) of cases fall into one of the six identifi ed subtypes of adjustment disorder: a) 18,5% (4/21), disruptive mood
dysregulation disorder (cat. 8); b) 13,7% (3/21), maladaptive separation disorder (cat. 9); c) 23,4% (5/21), oppositional defi ant disorder (cat. 10); d) 23,4% (5/21), explosive-
intermittent disorder (cat. 11); e) 7,3% (1/21), uninhibited social engagement disorder (cat. 12); f) 13,7% (3/21), attachment disorder (cat. 13).
Conclusions: It can therefore be concluded, with all the limitations of the selected population sample, which is not representative, that the hypothesis of considering
PAS (or PAD) as a variant of the general adaptation disorder, due to parental behaviour that feeds the dysfunctionality of the trauma suffered by the minor, can be
substantially correct, also pointing out the correlation between the severity of the symptoms suffered (and the psychopathological condition found) and the prolonged
exposure to stressful events.
Research Article
Parental Alienation Syndrome
(PAS): Defi nition, humanistic
profi les and clinical hypothesis
of absorption with “adaptation
disorder”. Clinical evidences
Giulio Perrotta*
Psychologist sp.ing in Strategic Psychotherapy, Forensic Criminologist, Legal Advisor sp.ed SSPL,
Researcher, Essayist, Institute for the study of psychotherapies - ISP, Via San Martino della Battaglia
no. 31, 00185, Rome, Italy
Received: 09 April, 2021
Accepted: 03 July, 2021
Published: 05 July, 2021
*Corresponding author: Dr. Giulio Perrotta, Psy-
chologist sp.ing in Strategic Psychotherapy, Forensic
Criminologist, Legal Advisor sp.ed SSPL, Researcher,
Essayist, Institute for the study of psychotherapies
- ISP, Via San Martino della Battaglia no. 31, 00185,
Rome, Italy, E-mail:
ORCID: https://orcid.org/0000-0003-0229-5562
Keywords: Parental alienation syndrome; Parental
alienation disorder; Psychopathology; PICI-1; DSM-V
https://www.peertechzpublications.com
Introduction
“Parental Alienation Syndrome” (PAS) is a controversial
psychological dysfunctional dynamic that, according to the
1985 theories of US physician Richard Gardner, is activated on
minor children involved in both parental separation and divorce
(defi ned as “confl ictual”) and in contexts of alleged intra-
household and family violence [1]. Gardner himself defi nes
it as a disorder that normally arises in the context of child
custody disputes, defi ned in three degrees, in ascending order
of infl uence, each to be treated with a specifi c psychological
and legal approach; it would therefore be the consequence
of an alleged (voluntary or involuntary) ‘reprogramming’ of
children by a pathological parent (so-called ‘alienating’), a
sort of brainwashing that would lead children to lose contact
with the reality of affections and to display unjustifi ed and
continuous resentment and contempt towards the other parent
(so-called ‘alienated’), using disparaging expressions referring
to the other parent, false accusations of neglect towards the
child, violence or abuse (in the worst cases, even sexual abuse),
the construction of a “virtual family reality” of terror and
harassment that would generate, in the children, deep feelings
037
https://www.peertechzpublications.com/journals/open-journal-of-pediatrics-and-child-health
Citation: Perrotta G (2021) Parental Alienation Syndrome (PAS): Definition, humanistic profiles and clinical hypothesis of absorption with “adaptation disorder”.
Clinical evidences. Open J Pediatr Child Health 6(1): 036-042. DOI: https://dx.doi.org/10.17352/ojpch.000035
4) The phenomenon of the independent thinker indicates
the child’s determination to assert that he or she is a
person who can reason without infl uence and that he
or she has worked out the terms of the denigration
campaign on his or her own without input from the
“alienating” parent;
5) The automatic support to the “alienating” parent is
a stance of the child always and only in favour of the
“alienating” parent, whatever kind of confl ict arises;
6) The absence of guilt, whereby all expressions of contempt
towards the ‘alienated’ parent fi nd justifi cation in the
fact that they are deserved, a sort of ‘just punishment’;
7) The borrowed scenarios, i.e. statements that cannot
reasonably come directly from the child, such as the
use of phrases, words, expressions or the quotation of
situations not normally inherent to a child of that age to
describe the faults of the excluded parent
8) The extension of hostilities to the extended family of the
rejected parent, involving, in the alienation, the family,
friends and new emotional relationships (a partner or
companion) of the rejected parent.
Gardner stated that, in his opinion, the uncontrolled
instillation of PAS would be a true form of emotional violence,
capable of producing signifi cant trauma both in the present
and in the future lives of the children involved [6,8,10,12-
15]. These consequences include severe psychopathological
processes such as: altered reality examination; narcissism;
weakening of the capacity to feel empathy; lack of respect for
authority (even to the point of externalizing typically antisocial
traits), extended also to non-parental fi gures; paranoia;
psychopathologies linked to gender identity; and, fi nally, a lack
of respect for authority [16-40, 51-57].
According to Gardner [41-44], PAS could present itself
at the moment of diagnosis, like any other pathology, even
with different levels of severity (mild, moderate, severe
PAS), depending on the intensity and effectiveness of the
programming. Moreover, the author hypothesised that,
depending on the greater or lesser appropriateness of the
chosen therapy, PAS could in fact evolve
a) In a resolving sense (disappearance of symptoms and
complete remission);
b) In an ameliorative direction (with symptomatic relief
and partial remission);
c) In a stabilising direction (with constant severity of
symptoms);
d) In a worsening sense (worsening of the pathology, up to
the state of “living death”).
The parenting aspects of separations could be clearly
defi ned, if one could fully understand the concept that, in the
family, there are two ‘couple entities’, distinct in their mutual
rights, duties and responsibilities: the ‘marital couple’ and
of fear, distrust and hatred towards the “alienated” parent. The
children would then ally themselves with the suffering parent,
showing themselves to be infected by that suffering, beginning
to support the vision of the ‘alienating’ parent. According to
Gardner, such ‘programming’ would destroy the relationship
between the children and the ‘alienated’ parent, as the former
would refuse any contact, even by telephone, with the latter
[2].
The following criteria should be checked for the presence
of PAS [3-5]:
1) The child reports the abuse only if spurred on by the
supporting parent
2) Existence of a contradiction between the child’s
accusation and the comfortable presence of the accused
parent
3) A lively and quarrelsome participation of the parent
who supports the complaint;
4) A tendency to manipulate on the part of the juvenile or
a clear need to please. However, four other diagnostic
criteria were later identifi ed:
5) Transitional diffi culties when the child separates from
the alienating parent to spend visitation time with the
alienated parent;
6) antagonistic or destructive behaviour during visits with
the alienated parent;
7) Pathological or paranoid bonding with the alienating
parent;
8) Strong and healthy bond with the alienated parent
before the alienation process took place.
Gardner’s theory, however, suggests basing the diagnosis
of PAS also on the observation of eight presumed primary
symptoms in the child [6-11]:
1) The denigration campaign, in which the child mimics
and mimics the “alienating” parent’s messages of
contempt towards the “alienated” parent. In a normal
situation each parent would not allow the child to show
disrespect and slander the other. In PAS, however, the
‘alienating’ parent does not question such disrespect,
but may even go so far as to encourage it;
2) The weak rationalisation of the rancour, whereby the
child explains the reasons for his discomfort in the
relationship with the alienated parent with illogical,
senseless or even merely superfi cial reasons (examples
cited, “He always raises his voice when he tells me
to brush my teeth”, or “He always tells me “Don’t
interrupt!”);
3) the lack of ambivalence, whereby the rejected parent is
described by the child as “completely negative” whereas
the other is seen as “completely positive”;
038
https://www.peertechzpublications.com/journals/open-journal-of-pediatrics-and-child-health
Citation: Perrotta G (2021) Parental Alienation Syndrome (PAS): Definition, humanistic profiles and clinical hypothesis of absorption with “adaptation disorder”.
Clinical evidences. Open J Pediatr Child Health 6(1): 036-042. DOI: https://dx.doi.org/10.17352/ojpch.000035
the ‘parental couple’. A ‘marital confl ict’, therefore, does not
necessarily (or must) also trigger a ‘parental confl ict’, and
any confl icts between the two entities could be addressed with
the help of family mediation. In part, the rules governing the
‘separation’ event may contribute to the problem. In order to
govern the world of affection, one sometimes relies on a ‘global
system of antagonisms’, on mechanisms of judicial confl ict,
on a ‘procedural truth’ with a winning party and a losing
party. The institution of single-parent custody, so widely
used in the past, is an element that reinforces the perspective
in terms of “winner and loser”. In the judicial context and,
more generally, within the “global system of antagonisms”,
children often assume the role of “defenceless civilians” in
a war of domination: real losers of an ideological vision that
identifi es a spouse/parent/children nucleus in the role of
the victim, and the losing spouse/parent in the role of the
violent and cruel executioner. A detachment from the reality
of parental affection, which - according to theories - could
trigger the Parental Alienation Syndrome when a parent comes
to perceive the children as non-persons: as a means, that is, to
acquire more power in the confl ict, or as a tool to give vent and
satisfaction to feelings of anger and discomfort typical of the
‘married couple’. It is the passage to the act, the overcoming
of the perception and the loss of the boundaries of the self,
the direct use of the children as a “relational weapon” in the
confl ict of the “married couple”, one of the factors that can
lead to the onset of PAS [8,10].
Gardner’s theories and research results on the subject of
parental alienation syndrome have, however, been the subject
of criticism both from a legal and a strictly clinical point of view,
due to their alleged lack of scientifi c validity and reliability,
despite the fact that in 2010-2011 the European Court of Human
Rights in Strasbourg ruled in favour [2]. For these reasons, the
hypothesis of a redefi nition into “Parental Alienation Disorder”
(PAD), as proposed by Bernet (one of the main proponents of
the inclusion of PAS in the fi fth edition of the DSM), has been
debated for years [45,46]. What emerges clearly is the very
scarce number of scientifi c works supporting the research on
the validity and reliability of Gardner’s theory, including the
will of the working group of the fi fth revision of the DSM [47]
not to include PAS in the Diagnostic and Statistical Manual of
Mental Disorders because of its unscientifi c nature.
Working hypothese and methodologies
If we try to analyse PAS and its possible redefi nition as PAD
from a technical point of view, a number of elements emerge
which, in the writer’s opinion, merit attention:
1) The hypotheses in which PAS would apply would not include
the hypotheses of actual abuse, violence and neglect. This is because
PAS is a perpetrated and continuous condition of psychological
violence, from which future psychopathologies would spring.
Even if one were to admit the psychological nature of PAS, one
would still have to consider, for the purposes of its objective
existence and effective manifestation, variability factors that
could condition its origin and course. Reference should be made
to aspects such as age, gender, the degree of communication
and cognition reached by the child, as well as the possibility
that the alienating parent accepts to take charge in order to re-
establish a functional communication between the child and
his/her spouse, in order to neutralise the effects of the previous
harmful behaviour towards the alienated person.
2) The symptomatology described in subjects aff ected by
PAS falls perfectly within other nosographies already contained
in the DSM-V. In particular we are talking about “adjustment
disorder”, which occurs when an individual has signifi cant
diffi culty in adapting to or coping with a signifi cant psychosocial
stressor. The maladaptive response usually involves otherwise
normal emotional and behavioural reactions that occur more
intensely than usual (taking into account contextual and
cultural factors), causing severe distress, preoccupation with
the stressor and its consequences, and functional impairment.
Common features include mild depressive symptoms, anxiety
symptoms and traumatic stress symptoms or a combination
of the three. According to the DSM-5, there are six distinct
types, which are characterised by the following predominant
symptoms: depressed mood, anxiety, depression mixed with
anxiety, conduct disorder, mixed emotion and conduct disorder,
and ‘unspecifi ed’. Unlike major depression, the disorder is
caused by an external stressor and generally resolves once the
individual is able to adapt to the situation. The condition is
different from anxiety disorder, which lacks the presence of
a stressor, or from post-traumatic stress disorder and acute
stress disorder, which are usually associated with a more
intense stressor. People exposed to repeated trauma are at
greater risk, even if that trauma is in the distant past. Age may
be a factor because young children have fewer coping resources;
children are also less likely to assess the consequences of a
potential stressor. A stressor is generally an event of a severe
and unusual nature that an individual or group of individuals
experiences. Stressors that cause adjustment disorders may be
severely traumatic or relatively minor, such as the loss of a
partner, a poor report card or moving to a new neighbourhood.
It is thought that the more chronic or recurrent the stressor
is, the more likely it is to produce a disorder. The objective
nature of the stressor is of secondary importance. The most
crucial link of stressors with their pathogenic potential is their
perception by the patient as stressful. The presence of a causal
stressor is essential before a diagnosis of adjustment disorder
can be made. There are some stressors that are more common
in different age groups; in adulthood these are marital confl ict,
fi nancial confl ict, health problems for oneself, one’s partner
or dependent children, personal tragedies such as death or
personal loss and job loss or unstable working conditions,
e.g. takeover or dismissal of a company; in childhood and
adolescence these are family confl ict or separation of parents,
school problems or changing schools, sexuality problems,
death, illness or trauma in the family. In time this condition
may evolve into other more structured and marked disorders
[10, 48]. In any case, a targeted psychotherapeutic intervention
is necessary [49,50].
Without calling into question new nosographic structures
and diagnostic modifi cations, the writer suggests excluding the
hypothesis of including PAS (or PAD) in the psychodiagnostic
manual and speaking instead of a form of adaptation disorder.
039
https://www.peertechzpublications.com/journals/open-journal-of-pediatrics-and-child-health
Citation: Perrotta G (2021) Parental Alienation Syndrome (PAS): Definition, humanistic profiles and clinical hypothesis of absorption with “adaptation disorder”.
Clinical evidences. Open J Pediatr Child Health 6(1): 036-042. DOI: https://dx.doi.org/10.17352/ojpch.000035
Results
Trying to support this hypothesis, the writer administered
the PICI-1 (version C) [58-62] to a restricted and non-
representative sample of patients (21 subjects, 8 males and
13 females), all aged between 4 and 10 years, with a clinically
relevant behavioural manifestation (and a presumed “label”
of parental alienation), with parents undergoing a marital
separation that had not yet been concluded and in a confl ictual
or in any case diffi cult intra-familiar relational context, in
the absence of a well-defi ned psychopathological picture or
diagnosed by the public neuropsychiatric service.
The selected setting, taking into account the protracted
pandemic period (already in progress since the beginning of
the present research), is the online platform via Skype and
Videocall Whatsapp, both for the clinical interview and for the
administration. The present research work was carried out
from July 2019 to June 2021. All participants were guaranteed
anonymity and being a sample population under the age of
18, specifi c authorization has been requested from parents or
guardians, in accordance with the law. This research has no
fi nancial backer and does not present any confl icts of interest.
The dictates of the Helsinki Convention of 1964 have been
respected.
Before presenting the result of the administration of the
PICI-1 (version C), it is necessary to specify that in the clinical
interview used, “adjustment disorder” was actually broken
down to better adapt to the clinical reality. In the theoretical
model of the PICI-1, for the part of the children’s disorders,
one does not fi nd the category “adjustment disorder” because
this latter is the macrocategory of six other disorders:
a) 18,5% (4/21). Disruptive Mood Dysregulation Disorder
(cat. 8), as a habitual, persistent and pervasive pattern, with
onset between fi ve and ten years of age, characterised by
systematic and persistent irritability involving outbursts of
anger, aggression and frequent mood swings: severe explosions
of anger; current explosions of anger, at least three episodes
per week; violent physical and/or verbal reactions; physical
and/or verbal reactions disproportionate in both duration and
intensity; reactions of anger and/or violence incompatible with
age; irritable mood for a good part of the day; negative feelings
directed towards the family, friend and/or school environment;
low tolerance of anxiety and/or frustration; intolerance of
any form of education contrary to the child’s wishes and/or
expectations.
b) 13,7% (3/21). Maladaptive Separation Disorder (cat. 9),
as a habitual, persistent and pervasive pattern, with onset
between the ages of two and four years, characterised by
systematic and persistent diffi culty in letting go of parents
or caregivers, constant and excessive fear that something
tragic will happen to them and systematic refusal to leave
home or remain alone in the home: diffi culty in letting go of
parents or own caregiver; explosions of anger; violent physical
and/or verbal reactions; physical and/or verbal reactions
disproportionate in both duration and intensity; constant and/
or excessive fear that something tragic will happen to them or
their caregiver; Easily irritable, anxious and/or depressed mood
(with notes of apathy, restlessness and strong melancholy) in
the presence of a separating circumstance; negative feelings
directed towards the separating event; low tolerance of anxiety
and/or frustration; systematic refusal to leave home and/or
remain alone in the home.
c) 23,4% (5/21). Oppositional Defi ant Disorder (cat. 10),
as a habitual, persistent and pervasive pattern, with onset
between fi ve and ten years of age, characterised by systematic
and persistent diffi culty in regulating and controlling one’s
emotions and behaviour: choleric and/or easily irritable mood;
explosions of anger; violent physical and/or verbal reactions;
physical and/or verbal reactions disproportionate in both
duration and intensity; oppositional behaviour; vengeful
behaviour; negative feelings towards those in authority; low
tolerance of anxiety and/or frustration; traits of hyperactivity.
d) 23,4% (5/21). Explosive-Intermittent Disorder (cat.
11), as a habitual, persistent and pervasive pattern, with
onset between four and eight years of age, characterised by
systematic and persistent diffi culty in managing anger and
rage: choleric and/or easily irritable mood; explosions of anger;
violent physical and/or verbal reactions; physical and/or verbal
reactions disproportionate in both duration and intensity;
behaviour in reaction to events wrongly perceived as damaging
to one’s personal sphere; poor management of anger and/or
rage, even in completely harmless events; negative feelings
directed towards third parties; low tolerance of anxiety and/
or frustration; poor ability to resist aggressive and/or violent
impulse.
e) 7,3% (1/21). Uninhibited Social Engagement Disorder (cat.
12), as a habitual, persistent and pervasive pattern, with onset
between fi ve and ten years of age, characterised by systematic
and persistent displays of excessively physical and uninhibited
behaviour towards others: unstable mood; uninhibited verbal
behaviour with persons not belonging to the family nucleus;
uninhibited physical behaviour with persons not belonging to
the family nucleus; direct and excessively friendly approach
with persons not belonging to the family nucleus; attention-
seeking with persons not belonging to the family nucleus;
constant need for physical contact with persons not belonging
to the family nucleus; excessively trusting feelings directed
towards third parties (not previously known); low tolerance to
anxiety and/or frustration with respect to the search for contact
and attention; absence of reticence or hesitation in leaving the
safe place with unknown persons.
f) 13,7% (3/21). Attachment Disorder (cat. 13), as a
habitual, persistent and pervasive pattern, with onset between
two and fi ve years of age, which refers to the disturbed and/or
inadequate social relational mode that characterises the child
in relation to his level of psychosocial development, either due
to a distortion of the secure base, or to a total or partial absence
of attachment. Two main clinical forms are known: INHIBITED
TYPE (13a): diffi culty in establishing interpersonal relationships;
dysfunctional adaptation to common life circumstances;
excessive inhibition; excessive hypervigilance; contradictory
attitude towards caregivers; little social involvement;
040
https://www.peertechzpublications.com/journals/open-journal-of-pediatrics-and-child-health
Citation: Perrotta G (2021) Parental Alienation Syndrome (PAS): Definition, humanistic profiles and clinical hypothesis of absorption with “adaptation disorder”.
Clinical evidences. Open J Pediatr Child Health 6(1): 036-042. DOI: https://dx.doi.org/10.17352/ojpch.000035
diffi culty in affective regulation; low tolerance to anxiety and/
or frustration; unexplainable fear and/or outbursts of anger.
DISINHIBITED TYPE (13b): easiness to engage in interpersonal
relationships; independent and overly functional adaptation
to the circumstances of common life; excessive disinhibition;
excessive hypovigilance; excessive search for detachment and
separation from caregivers; excessive social involvement and/
or excessive sociability; affective overregulation; low tolerance
to anxiety and/or frustration with respect to loneliness; lack of
shyness towards the stranger with whom he has contact.
All these six disorders, in children, are the consequence
of trauma or repeated dysfunctional behaviour that has
prevented the child from adapting in a functional way to future
circumstances.
On this theoretical basis, therefore, the administration of
the PICI-1C clinical interview confi rmed the initial hypothesis
of the “adaptation disorder”, in its six variants, in 100% of the
cases, as shown in the table:
No. Age /
gender
Exposure
to
stressful
events
Symptoms suffered before pici-1c administration
1 4/M 3 years anger, aggression, impulsiveness
2 4/M 4 years excessive need for attention, excessive need for care,
phobias
3 5/M 4 years excessive need for attention, excessive need for care,
obsessive thoughts, diffi cult to deal with frustration
4 5/M 4 years excessive need for attention, excessive need for care,
obsessive thoughts
5 5/M 2 years anger, aggression, impulsiveness, excessive need for
attention
6 6/M 1 year anger, aggression, impulsiveness
7 6/M 3 years excessive need for attention, excessive need for care,
obsessive thoughts
8 6/M 2 years anger, aggression, impulsiveness, excessive need for
attention
9 6/F 2 years anger, aggression, impulsiveness, excessive need for
attention
10 7/F 4 years excessive need for attention, excessive need for care,
obsessive thoughts
11 7/F 3 years anger, aggression, impulsiveness, excessive need for
attention
12 7/F 2 years anger, aggression, impulsiveness, excessive need for
attention
13 8/F 6 years excessive need for attention, excessive need for care,
obsessive thoughts, diffi cult handling of frustration
14 9/F 2 years excessive need for attention, excessive need for care,
obsessive thoughts
15 9/F 5 years anger, aggression, impulsiveness, excessive need for
attention
16 9/F 6 years
diffi cult management of frustration,
transgression of social and cohabitation rules,
anti-social and anti-authority behaviour
17 9/F 1 year anger, aggression, impulsiveness
18 9/F 4 years excessive need for care, phobias, panic
19 10/F 5 years
diffi cult management of frustration,
transgression of social and cohabitation rules,
anti-social and anti-authority behaviour
20 10/F 6 years anger, aggression, impulsiveness,
panic attacks, obsessive thoughts
21 10/F 8 years
obsessive thoughts, aggression,
impulsiveness, diffi cult handling of frustration,
transgression of social rules and rules of coexistence
anti-social and anti-authority behaviour
The limits of this research are:
1) The use of a population sample that is not suffi ciently
representative, although the result of 100% suggests a
good reliability of the psychodiagnostic instrument if
applied to a larger sample of the population.
2) PICI-1 consists of two clinical interviews, based on
the age of the interviewed subject; however, the one
referring to the child and pre-adolescent age cannot
be used in relation to MMPI-II because the theoretical
assumption, the reference model and the nosography
used are different.
3) PICI-1 is not yet standardised psychometric instrument
but are proposed, despite the excellent results obtained
and already published in international scientifi c journals
[58-62].
Working hypothese and methodologies
It can therefore be concluded, with all the limitations of
the selected population sample, which is not representative,
that the hypothesis of considering PAS (or PAD) a variant of
the general adaptation disorder, due to parental behaviour that
feeds the dysfunctionality of the trauma suffered by the minor,
can be substantially correct, also pointing out the correlation
between the severity of the symptoms suffered (and the
psychopathological condition found) and the prolonged
exposure to stressful events.
References
1. Vaccaro S, Barea C (2011) PAS. Presunta Sindrome di Alienazione Genitoriale,
Edit press, Firenze.
2. Pingitore M (2019) Nodi e snodi nell’alienazione parentale. Nuovi strumenti
psicoforensi per la tutela dei diritti dei fi gli, Milano, Franco Angeli Ed.
3. Gardner RA (1985) Recent Trends in Divorce and Custody Litigation.Academy
Forum. Bloomfi eld, The American Academy of Psychoanalysis and Dynamic
Psychiatry 29. Link: https://bit.ly/3hyaX9L
4. Gardner RA (1998) Recommendations for Dealing with Parents who Induce a
Parental Alienation Syndrome in their Children. Journal of Divorce & Remarriage
28. Link: https://bit.ly/3hz4Fa7
5. Gardner RA (2001) Should Courts Order PAS Children to Visit/Reside with
the Alienated Parent? A Follow-up Study.The American Journal of Forensic
Psychology 19. Link: https://bit.ly/3qO8snS
6. Camerini GB, Pingitore M, Lopez G (2016)Alienazione parentale. Innovazioni
cliniche e giuridiche, Milano, Franco Angeli Ed. Link: https://bit.ly/3dLoQk1
7. Fornari U (2015)Trattato di psichiatria forense, Utet Giuridica
8. Perrotta G (2019) Psicologia generale, Luxco Ed., 1st ed.
9. Perrotta G (2019) Psicologia dinamica, Luxco Ed., 1st ed.
10. Perrotta G (2019) Psicologia clinica, Luxco Ed., 1st ed.
11. Perrotta G (2019) The reality plan and the subjective construction of one’s
041
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Citation: Perrotta G (2021) Parental Alienation Syndrome (PAS): Definition, humanistic profiles and clinical hypothesis of absorption with “adaptation disorder”.
Clinical evidences. Open J Pediatr Child Health 6(1): 036-042. DOI: https://dx.doi.org/10.17352/ojpch.000035
perception: the strategic theoretical model among sensations, perceptions,
defence mechanisms, needs, personal constructs, beliefs system, social
infl uences and systematic errors. J Clinical Research and Reports 1. Link:
https://bit.ly/3b34baH
12. Perrotta G (2020) Psychological trauma: defi nition, clinical contexts, neural
correlations and therapeutic approaches. Curr Res Psychiatry Brain Disord:
CRPBD-100006. Link: https://bit.ly/37UD3bz
13. Perrotta G (2020) Human mechanisms of psychological defence: defi nition,
historical and psychodynamic contexts, classifi cations and clinical profi les. Int
J Neurorehabilitation Eng 7: 1. Link: https://bit.ly/2L0I5dJ
14. Perrotta G (2020)Dysfunctional attachment and psychopathological
outcomes in childhood and adulthood. Open J Trauma 4: 012-021. Link:
https://bit.ly/3bhnXPg
15. Perrotta G (2020)Neonatal and infantile abuse in a family setting. Open J
Pediatr Child Health 5: 034-042. Link: https://bit.ly/37Ty2je
16. Perrotta G (2019)Attention Defi cit Hyperactivity Disorder: defi nition,
contexts, neural correlates and clinical strategies. J Addi Adol Beh 2. Link:
https://bit.ly/3hyNCVE
17. Perrotta G (2019)Specifi c learning and language disorders: defi nitions,
differences, clinical contexts and therapeutic approaches. J Addi Adol Beh 2.
Link: https://bit.ly/3hh68Tx
18. Perrotta G (2019) Tic disorder: defi nition, clinical contexts, differential
diagnosis, neural correlates and therapeutic approaches. J Neurosci Rehab 1-6.
Link: https://bit.ly/3rEagQm
19. Perrotta G (2019) Anxiety disorders: defi nitions, contexts, neural correlates
and strategic therapy. J Neur Neurosci 6: 046. Link: https://bit.ly/2WSmiaT
20. Perrotta G (2019) Neural correlates in eating disorders: Defi nition,
contexts and clinical strategies. J Pub Health Catalog 2: 137-148. Link:
https://bit.ly/3mWmf8s
21. Perrotta G (2019) Post-traumatic stress disorder: Defi nition, contexts, neural
correlations and cognitive-behavioral therapy. J Pub Health Catalog 2: 40-47.
Link: https://bit.ly/3rvaCc6
22. Perrotta G (2019) Sleep-wake disorders: Defi nition, contexts and neural
correlations. J Neurol Psychol 7: 09. Link: https://bit.ly/3hoBiGO
23. Perrotta G (2019) Depressive disorders: Defi nitions, contexts, differential
diagnosis, neural correlates and clinical strategies. Arch Depress Anxiety 5:
009-033. Link: https://bit.ly/2KADvDm
24. Perrotta G (2019) Panic disorder: defi nitions, contexts, neural correlates
and clinical strategies. Current Trends in Clinical & Medical Sciences 1. Link:
https://bit.ly/38IG6D5
25. Perrotta G (2019) Obsessive-Compulsive Disorder: defi nition, contexts, neural
correlates and clinical strategies. Cientifi c Journal of Neurology 1: 08-16. Link:
https://bit.ly/3pxNbNu
26. Perrotta G (2019) Behavioral addiction disorder: defi nition, classifi cations,
clinical contexts, neural correlates and clinical strategies. J Addi Adol Beh 2.
Link: https://bit.ly/3rAT9ip
27. Perrotta G (2019) Delusions, paranoia and hallucinations: defi nitions,
differences, clinical contexts and therapeutic approaches. Cientifi c Journal of
Neurology (CJNE) 1: 22-28.
28. Perrotta G (2019) Paraphilic disorder: defi nition, contexts and clinical
strategies.J Neuro Research 1: 4. Link: https://bit.ly/3gxr1t3
29. Perrotta G (2019)Internet gaming disorder in young people and adolescent: a
narrative review. J Addi Adol Beh 2. Link: https://bit.ly/3rTbAyZ
30. Perrotta G (2019) Bipolar disorder: defi nition, differential diagnosis, clinical
contexts and therapeutic approaches. J Neuroscience and Neurological
Surgery 5. Link: https://bit.ly/34SoC67
31. Perrotta G (2020) Suicidal risk: defi nition, contexts, differential diagnosis,
neural correlates and clinical strategies. J Neuroscience Neurological Surgery
6: 114. Link: https://bit.ly/3aMqcu5
32. Perrotta G (2020) Pathological gambling in adolescents and adults: defi nition,
clinical contexts, differential diagnosis, neural correlates and therapeutic
approaches. ES J Neurol 1: 1004. Link: https://bit.ly/34RmUlj
33. Perrotta G (2020) Pedophilia: defi nition, classifi cations, criminological and
neurobiological profi les and clinical treatments. A complete review. Open J
Pediatr Child Health 5: 019-026. Link: https://bit.ly/38Jzggz
34. Perrotta G (2020)The concept of altered perception in “body dysmorphic
disorder”: the subtle border between the abuse of selfi es in social networks
and cosmetic surgery, between socially accepted dysfunctionality and
the pathological condition. J Neurol Neurol Sci Disord 6: 001-007. Link:
https://bit.ly/3wffHXp
35. Perrotta G (2020)Sexual orientations: a critical review of psychological,
clinical and neurobiological profi les. Clinical hypothesis of homosexual
and bisexual positions. Int J Sex Reprod Health Care 3: 027-041. Link:
https://bit.ly/38DtEVa
36. Perrotta G (2020) Cuckolding and Troilism: defi nitions, relational and clinical
contexts, emotional and sexual aspects and neurobiological profi les. A
complete review and investigation into the borderline forms of the relationship:
Open Couples, Polygamy, Polyamory. Annals of Psychiatry and Treatment,
Ann Psychiatry Treatm 4: 037-042. Link: https://bit.ly/2TFODD3
37. Perrotta G (2020)Borderline Personality Disorder: defi nition, differential
diagnosis, clinical contexts and therapeutic approaches. Ann Psychiatry
Treatm 4: 043-056. Link: https://bit.ly/3hx2B1N
38. Perrotta G (2020)Narcissism and psychopathological profi les: defi nitions,
clinical contexts, neurobiological aspects and clinical treatments. J Clin Cases
Rep 4: 12-25. Link: https://bit.ly/2X8wzzF
39. Perrotta G (2020)Dysfunctional sexual behaviors: defi nition, clinical contexts,
neurobiological profi les and treatments. Int J Sex Reprod Health Care 3: 061-
069. Link: https://bit.ly/3hxT4aU
40. Perrotta G (2020)Bisexuality: Defi nition, humanistic profi les, neural correlates
and clinical hypotheses. J Neuroscience and Neurological Surgery 6. Link:
https://bit.ly/2LpzwJx
41. Brown AL (2008)Criminal Rewards: The Impact of Parent Alienation Syndrome
on Families.Affi lia 23: 388-396. Link: https://bit.ly/3htjuuw
42. Faller KC(1998) The Parental Alienation Syndrome: What is it and What Data
Support it?.Child Maltreatment American Professional Society on the Abuse of
Children. Link: https://bit.ly/3AoQiOh
43. Bruch CS (2001) Parental Alienation Syndrome and Parental Alienation:
Getting It Wrong in Child Custody Cases.Family Law Quarterly35. Link:
https://bit.ly/3hyZEOz
44. Wood CL (2012) The Parental Alienation Syndrome: A Dangerous Aura of
Reliability.Loyola of Los Angeles Law Review 29.
45. Bernet W (2008)Parental Alienation Disorder and DSM-V. American Journal of
Family Therapy 36: 349-366. Link: https://bit.ly/2TEG0sx
46. Bernet W (2017)Understanding the reality of parental alienation. Elsevier
Science Direct 43: 507-509. Link: https://bit.ly/2SPNp88
47. APA (2013) DSM-V, Washington.
48. Maercker A, Lorenz L (2018) Adjustment disorder diagnosis: Improving clinical
utility.World J Biol Psychiatry 19: S3-S13. Link: https://bit.ly/3e1Wlif
042
https://www.peertechzpublications.com/journals/open-journal-of-pediatrics-and-child-health
Citation: Perrotta G (2021) Parental Alienation Syndrome (PAS): Definition, humanistic profiles and clinical hypothesis of absorption with “adaptation disorder”.
Clinical evidences. Open J Pediatr Child Health 6(1): 036-042. DOI: https://dx.doi.org/10.17352/ojpch.000035
49. Perrotta G (2020) The strategic clinical model in psychotherapy: theoretical
and practical profi les. J Addi Adol Behav 3: 5. Link: https://bit.ly/3aPMx9X
50. Perrotta G (2020)Accepting “change” in psychotherapy: from consciousness
to awareness. Journal of Addiction Research and Adolescent Behaviour 3.
51. Perrotta G (2020) Affective Dependence: from pathological affectivity to
personality disorders. Defi nitions, clinical contexts, neurobiological profi les
and clinical treatments. Health Sci 1: 1-7. Link: https://bit.ly/2TXmTdj
52. Perrotta G (2020) Psychotic spectrum disorders: defi nitions, classifi cations,
neural correlates and clinical profi les. Ann Psychiatry Treatm 4: 070-084. Link:
https://bit.ly/2TeoESI
53. Perrotta G (2021) Maladaptive stress: Theoretical, neurobiological and clinical
profi les. Arch Depress Anxiety 7: 001-007. Link: https://bit.ly/3xihqw5
54. Perrotta G (2021) Etiological factors and comorbidities associated with
the “Gender Dysphoria”: Defi nition, clinical contexts, differential diagnosis
and clinical treatments. Int J Sex Reprod Health Care 4: 001-005. Link:
https://bit.ly/3xjddbK
55. Perrotta G (2021) The state of consciousness: from perceptual alterations
to dissociative forms. Defi ning, neurobiological and clinical profi les. J Neuro
Neurol Sci Disord 7: 006-018. Link: https://bit.ly/2TyN2yY
56. Perrotta G, Fabiano G (2021) Behavioural disorders in children and adolescents:
Defi nition, clinical contexts, neurobiological profi les and clinical treatments.
Open J Pediatr Child Health 6: 005-015. Link: https://bit.ly/3Ary6U7
57. Perrotta G (2021) Avoidant personality disorder: Defi nition, clinical and
neurobiological profi les, differential diagnosis and therapeutic framework. J
Neuro Neurol Sci Disord 7: 001-005. Link: https://bit.ly/3p5S9SP
58. Perrotta G (2020)Perrotta Integrative Clinical Interview.
59. Perrotta G (2020)The structural and functional concepts of personality: The
new Integrative Psychodynamic Model (IPM), the new Psychodiagnostic
Investigation Model (PIM) and the two clinical interviews for the analysis of
personality disorders (Perrotta Integrative Clinical Interview or PICI) for adults
and teenagers (1TA version) and children (1C version), Psychiatry Peertechz,
E-book. Link: https://bit.ly/2SqQevV
60. Perrotta G (2020)First revision of the Psychodiagnostic Investigation Model
(PIM-1R) and elaboration proposal of a clinical interview for the analysis
of personality disorders (Perrotta Integrative Clinical Interview or PICI-
1) for adults, teenagers and children. Psychiatry Peertechz, E-book. Link:
https://bit.ly/2MQe3dY
61. Perrotta G (2020) “Perrotta Integrative Clinical Interview (PICI-1)”:
Psychodiagnostic evidence and clinical profi les in relation to the MMPI-II, Ann
Psychiatry Treatm 4: 062-069. Link: https://bit.ly/3rqbgqX
62. Perrotta G (2021) “Perrotta Integrative Clinical Interview” (PICI) for adults and
teenagers (1TA version) and children (1C version): new theoretical models
and practical integrations between the clinical and psychodynamic approach.
Ann Psychiatry Treatm 5: 001-014. Link: https://bit.ly/3546iGM
63. Perrotta G (2021) Perrotta Integrative Clinical Interview (PICI-1): a new revision
proposal for PICI-1TA. Two single cases. Glob J Medical Clin Case Rep 8: 041-
049. Link: https://bit.ly/2UsevSY
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