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Pilot study of parental alienation items in the adverse childhood events scale
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Theory and research have described developmental processes leading to damaged parent–child relationships, such as those that occur during a divorce. However, scholars dispute the scientific status of the literature on children who form unhealthy alliances with one parent against the other—termed parental alienation (PA). This comprehensive literature review tests competing descriptions of the PA literature. Accessing four electronic databases, we identified 213 documents with empirical data on PA published in 10 languages through December 2020. The results confirmed that the current state of PA scholarship meets three criteria of a maturing field of scientific inquiry: an expanding literature, a shift toward quantitative studies, and a growing body of research that tests theory-generated hypotheses. Nearly 40% of the PA literature has been published since 2016, establishing that PA research has moved beyond an early stage of scientific development and has produced a scientifically trustworthy knowledge base. This literature review documents the value of multiple research methodologies to this knowledge base. In addition, the growing body of research described in this review enhances our understanding of the association between interparental conflict and the breakdown of parent–child relationships in families where conflict differentially affects children’s relationship with and behavior toward each parent.
Previous studies have demonstrated a connection between intimate partner violence (IPV) and a child’s alienation from the abused parent, but little is known about the relationships between the type of IPV, aspects, and severity of a child’s alienation, and the target parent’s gender. This study assessed the presence of an IPV history (verbal and physical aspects) among parents who identify as targets of their children’s unreasonable rejection. Also investigated were associations between the form of IPV and manifestations of a child’s alienated behavior, parent’s gender and type of IPV, and parents’ gender and degree of the child’s alienation. Self-identified alienated parents ( n = 842) completed an online survey that included an IPV screening measurement (Hurts, Insults, Screams, Threatens screening tool) and a measure of the parent’s perception of their child’s alienated behaviors (Rowlands Parental Alienation Scale). The majority identified as IPV victims and reported a higher level of verbal than physical abuse. More mothers than fathers identified themselves as IPV victims. As a group, IPV victims rated their child as more severely alienated than did non-IPV alienated parents. Mothers were more likely than fathers to report physical aggression by the other parent and more likely than fathers to assess their child’s alienated behaviors as more severe. Victims of physical violence reported their children were less likely to withhold positive affection from them. This knowledge may assist in earlier identification of the alienation process and greater recognition, legitimacy, funding, and opportunities for enhanced collaboration among stakeholders. This, in turn, may lead to improvements in prevention, intervention, and accountability, thus helping to interrupt alienation processes.
Adverse childhood experiences have a lasting impact on health across the life course. The perinatal period offers a unique opportunity to rework problematic dynamics in families experiencing intergenerational trauma. This study explores the family dynamics that are activated during the perinatal period and considers the potential for intervention with adolescent parents and their families in Lima, Peru. This narrative analysis was part of a broader study that included focus groups and in-depth interviews. Of the ten adolescent mothers interviewed, four narratives were selected for presentation in this manuscript. These particular narratives were selected to illustrate the diversity of the experiences among this group and for the exceptional level of detail provided about their life experiences and family relationships. Narrative excerpts were analyzed in the context of the entire interview and the aggregate content of other interviews in order to explore both explicit and implicit meanings. This study identified critical relational shifts among adolescent parents and their families during the perinatal period. In one instance, adolescent parenthood created an opportunity for the family to come together. In the other cases, conflict escalated, relations grew distant, or both. These narrative data demonstrate that intergenerational trauma can interfere with family relationships in the context of adolescent pregnancy and prevent adolescent parents from accessing needed support from their families. Intervention with families could address the impact of trauma and improve communication and collaboration.
This study qualitatively investigated the mental health of adults exposed to parental alienating behaviours in childhood. Research suggests that exposure to parental alienating behaviours in childhood can have a profound impact on the mental health of those children later in life, including experiencing anxiety disorders and trauma reactions. An international sample of 20 adults exposed to parental alienating behaviours in childhood participated in semi-structured interviews on their experience and its impact. Four themes were identified: mental health difficulties, including anxiety disorders and trauma reactions, emotional pain, addiction and substance use, and coping and resilience. Intergenerational transmission of parental alienation was found. Confusion in understanding their experience of alienation, the mental health sequelae, and elevated levels of suicidal ideation were found. This study demonstrated the insidious nature of parental alienation and parental alienating behaviours and provided further evidence of these behaviours as a form of emotional abuse.
After months of people sheltering in place, whether due to formal orders or to protect themselves from COVID-19, we have seen evidence of increases in Intimate Partner Violence (IPV). IPV, already a significant social justice issue worldwide, has been brought to the forefront during the pandemic, with many victims needing to be in confined spaces with their abusers. This chapter explores the experiences of sheltering in place for returning college students exposed to coercive control. It examines how coercive control, often intensified in post-separation abuse (PSA) and, where children are involved, parental alienation (PA), frequently manifests within families. Children have in the past been termed “secondary victims” of IPV, but this chapter will demonstrate how they should be considered primary victims of coercive control alongside their victimized parent. The particular challenges college students face during the COVID-19 pandemic when coercive control and PA are at issue will be delineated, and the many areas needing further research and exploration will be highlighted.
There has been a recent increase in the amount of research on male victims of female-perpetrated partner violence (PV), but research needs to be conducted to understand how the patterns of abuse persist in these relationships. In the current study, the experiences of 59 male PV victims in the United States, recruited through online advertisements in professional networks and websites (e.g., agencies that specialize in male victims of PV), were explored through a thematic analysis. Analyses suggested that the help-seeking process of male PV victims is complex and heterogeneous and can often lead to further negative consequences due to various structural, cultural, social, and organizational factors. The findings also highlight the potential societal issues that male victims perceived as contributing to male victimization and lack of available resources for them. The results are discussed in terms of its implications for agencies, service providers, and general societal attitudes that are relevant to raising awareness about this phenomenon.
Background:
Adversity experienced during childhood manifests deleteriously across the lifespan. This study provides updated frequency estimates of ACEs using the most comprehensive and geographically diverse sample to date.
Methods:
ACEs data were collected via BRFSS (Behavioral Risk Factor Surveillance System). Data from a total of 211,376 adults across 34 states were analyzed. The ACEs survey is comprised of 8 domains: physical/emotional/sexual abuse, household mental illness, household substance use, household domestic violence, incarcerated household member, and parental separation/divorce. Frequencies were calculated for each domain and summed to derive mean ACE scores. Findings were weighted and stratified by demographic variables. Group differences were assessed by post-estimation F-tests.
Results:
Most individuals experienced at least one ACE (57.8%) with 21.5% experiencing 3+ ACEs. F-tests showed females had significantly higher ACEs than males (1.64 to 1.46). Multiracial individuals had a significantly higher ACEs (2.39) than all other races/ethnicities, while White individuals had significantly lower mean ACE scores (1.53) than Black (1.66) or Hispanic (1.63) individuals. The 25-to-34 age group had a significantly higher mean ACE score than any other group (1.98). Generally, those with higher income/educational attainment had lower mean ACE scores than those with lower income/educational attainment. Sexual minority individuals had higher ACEs than straight individuals, with significantly higher ACEs in bisexual individuals (3.01).
Conclusion:
Findings highlight that childhood adversity is common across sociodemographic, yet higher in certain categories. Identifying at-risk populations for higher ACEs is essential to improving the health outcomes and attainment across the lifespan.
Parental alienation (rejection of a parent without legitimate justification) and realistic estrangement (rejection of a parent for a good reason) are generally accepted concepts among mental health and legal professionals. Alienated children, who were not abused, tend to engage in splitting and lack ambivalence with respect to their parents; estranged children, who were maltreated, usually perceive their parents in an ambivalent manner. The hypothesis of this study was that a psychological test—the Parental Acceptance–Rejection Questionnaire (PARQ)—will help to distinguish severely alienated from nonalienated children. The PARQ, which was used to identify and quantify the degree of splitting for each participant, was administered to 45 severely alienated children and 71 nonalienated children. The PARQ‐Gap score—the difference between each child's PARQ: Father score and PARQ: Mother score—was introduced and defined in this research. Using a PARQ‐Gap score of 90 as a cut point, this test was 99% accurate in distinguishing severely alienated from nonalienated children. This research presents a way to distinguish parental alienation from other reasons for contact refusal. The PARQ‐Gap may be useful for both clinicians and forensic practitioners in evaluating children of separating and divorced parents when there is a concern about the possible diagnosis of parental alienation.
Objectives
The purpose of the current study was to assess clinician reports of behaviors and attitudes of physically abused children in order to determine whether they generally behaved in a manner designed to maintain the attachment to the caregiver rather than disrupt the attachment.
Methods
Three hundred and thirty-eight clinicians were surveyed about the attitudes and behaviors of physically abused children. Some clinicians rated a specific severely abused child, some rated severely abused children in general, some rated a specific moderately abused child, and some rated moderately abused children in general. Half of the items on the survey pertained to attachment-enhancing behaviors (caring about the parent’s feelings, staying connected the family of the parent, minimizing the harm, and so forth) and half of the items reflected attachment-disrupting behaviors (idolizing the other parent, being rude towards the parent, expressing trivial reasons for being hurt with the parent, and so forth).
Results
For each of the four samples, abused children were rated as expressing significantly more attachment-enhancing behaviors than attachment-disrupting behaviors. They were also found to exhibit more extreme attachment enhancing behaviors than extreme attachment disrupting behaviors. For the most part, characteristics of the rater and the child were not associated with ratings.
Conclusions
Physically abused children were reported to want to maintain relationships with abusive caregivers, which presents challenges as well as opportunities for clinicians working with this highly vulnerable population.
Parental alienation has been an unacknowledged and poorly understood form of family violence. Research on parental alienation and the behaviors that cause it has evolved out of decades of legal and clinical work documenting this phenomenon, leading to what could be considered a “greening,” or growth, of the field. Today, there is consensus among researchers as to what parental alienating behaviors are and how they affect children and the family system. We review the literature to detail what parental alienation is, how it is different from other parent–child problems such as estrangement and loyalty conflicts, and how it is perpetuated within and across different social systems. We conclude by highlighting research areas that need further investigation to develop and test effective solutions for ameliorating the devastating effects of parental alienation that, we posit, should be considered and understood not only as abusive to the child but also as a form of family violence directed toward both the child and the alienated parent.
Background
The current study is aimed at examining the relationship between exposure to parental alienation (PA) behaviors, depression, and health-related quality of life (HRQoL) in Italian adults.
Methods
Four hundred ninety-one adults were tested. Participants filled out the following self-rating scales: The Baker Strategy Questionnaire (BSQ), the Beck Depression Inventory – II (BDI-II) and its brief version (6-item version of the BDI-II), the Short-Form 36 (SF-36) Health Survey for measuring HRQoL and its brief version including 3 items (WHO-3) of the 5-item World Health Organization Well-Being Index.
Results
Findings revealed statistically significant differences between participants who reported PA and those who did not. Participants who reported exposure to PA behaviors had higher scores on the original BDI-II and its 6-item version (p < 0.05, p < 0.01, respectively); they had also lower levels of HRQoL as resulting from 6 of the 8 SF-36 domains (at least p < 0.05), including lower scores on the WHO-3 (p < 0.01). Perceiving an exposure to PA behaviors significantly increased the likelihood of being above the clinical cut-off on the BDI-II (p < 0.01), the 6-item version of the BDI-II (p < 0.05), and the WHO-3 (p < 0.05). Moreover, perceiving an exposure to PA increased the odds of diminished HRQoL (OR = 2.43 and OR = 1.92 for general health and social functioning domains, respectively).
Conclusions
Childhood exposure to PA was related to higher likelihood of depressive symptoms and diminished HRQoL in adulthood. Our findings suggest the need for preventive and clinical interventions to protect vulnerable children involved in PA from negative outcomes.
The purpose of this study was to systematically review the literature on the prevalence of adverse childhood experiences (ACEs) in school-aged youth (i.e., ≤ 18 years). Inclusion and exclusion search criteria led to the identification of 96 articles published during a 25-year period. Articles containing international samples (N = 44) and samples from the United States (N = 52) were examined for (a) the nature and prevalence of ACEs, (b) the nature of the samples and populations studied, and (c) the methods used to identify ACEs. Findings are narratively summarized and presented descriptively in tabular form to further assist school professionals in recognizing the diversity of ACEs worldwide and the array of methods used to identify trauma-related events. Prevalence rates vary substantially by the type of ACEs reported and the context or setting in which data were gathered. Yet, almost two thirds of youth experience significant adverse events no matter where they reside across the world, highlighting the need for local ACEs screening and early intervention. Implications for future research include the importance of clarifying ACEs exposure and measures used to quantify such events to allow for future aggregation (e.g., meta-analysis) of findings by country, context, population, or event type.
Despite affecting millions of families around the world, parental alienation has been largely unacknowledged or denied by legal and health professionals as a form of family violence. This complex form of aggression entails a parental figure engaging in the long-term use of a variety of aggressive behaviors to harm the relationship between their child and another parental figure, and/or to hurt the other parental figure directly because of their relationship with their child. Like other forms of family violence, parental alienation has serious and negative consequences for family members, yet victims are often blamed for their experience. In order to be recognized as a form of family violence and to secure protection for victims under law and social policies, a formal review and comparison of parental alienating behaviors and outcomes to child abuse and intimate partner violence has been sorely needed. The result of this review highlights how the societal denial of parental alienation has been like the historical social and political denial or other forms of abuse in many parts of the world (e.g., child abuse a century ago). Reframing parental alienating behaviors as a form of family violence also serves as a desperate call to action for social scientists to focus more theoretical and empirical attention to this topic.
This study examined the mediating role of the six Difficulties with Emotion Regulation Scale (DERS) subscales in the relation between adverse childhood experiences (ACEs) and adult psychological distress in a clinical sample of adults receiving psychological treatment at a community-based mental health clinic. In the first part of the study, we found (a) a direct association between childhood adversity and adult psychological distress and (b) the DERS total score mediated this relation. In addition, the DERS subscales differentially mediated this relation. Specifically, the Nonacceptance of Emotional Responses, Impulse Control Difficulties, and Lack of Access to Emotion Regulation Strategies significantly affected psychological distress in adulthood. In the second part of the study, the moderating role of the level of exposure to ACEs in the abovementioned relation was analyzed. For individuals with low ACE scores, the relation between ACEs and adult psychological distress was mediated by four of the six DERS subscales (Nonacceptance of Emotional Responses, Difficulty Engaging in Goal-Directed Behavior, Impulse Control Difficulties, and Limited Access to Emotion Regulation Strategies). For individuals with high ACE scores, none of the DERS subscales significantly moderated the relation between ACEs and psychological distress. These findings suggest that how each dimension of emotional regulation contributes to distress among a marginalized urban population is a function of the level of trauma exposure. These data offer an important guidepost for clarifying impeding regulatory difficulties to target for future intervention work.
Importance
Early adversity is associated with leading causes of adult morbidity and mortality and effects on life opportunities.
Objective
To provide an updated prevalence estimate of adverse childhood experiences (ACEs) in the United States using a large, diverse, and representative sample of adults in 23 states.
Design, Setting, and Participants
Data were collected through the Behavioral Risk Factor Surveillance System (BRFSS), an annual, nationally representative telephone survey on health-related behaviors, health conditions, and use of preventive services, from January 1, 2011, through December 31, 2014. Twenty-three states included the ACE assessment in their BRFSS. Respondents included 248 934 noninstitutionalized adults older than 18 years. Data were analyzed from March 15 to April 25, 2017.
Main Outcomes and Measures
The ACE module consists of 11 questions collapsed into the following 8 categories: physical abuse, emotional abuse, sexual abuse, household mental illness, household substance use, household domestic violence, incarcerated household member, and parental separation or divorce. Lifetime ACE prevalence estimates within each subdomain were calculated (range, 1.00-8.00, with higher scores indicating greater exposure) and stratified by sex, age group, race/ethnicity, annual household income, educational attainment, employment status, sexual orientation, and geographic region.
Results
Of the 214 157 respondents included in the sample (51.51% female), 61.55% had at least 1 and 24.64% reported 3 or more ACEs. Significantly higher ACE exposures were reported by participants who identified as black (mean score, 1.69; 95% CI, 1.62-1.76), Hispanic (mean score, 1.80; 95% CI, 1.70-1.91), or multiracial (mean score, 2.52; 95% CI, 2.36-2.67), those with less than a high school education (mean score, 1.97; 95% CI, 1.88-2.05), those with income of less than $15 000 per year (mean score, 2.16; 95% CI, 2.09-2.23), those who were unemployed (mean score, 2.30; 95% CI, 2.21-2.38) or unable to work (mean score, 2.33; 95% CI, 2.25-2.42), and those identifying as gay/lesbian (mean score 2.19; 95% CI, 1.95-2.43) or bisexual (mean score, 3.14; 95% CI, 2.82-3.46) compared with those identifying as white, those completing high school or more education, those in all other income brackets, those who were employed, and those identifying as straight, respectively. Emotional abuse was the most prevalent ACE (34.42%; 95% CI, 33.81%-35.03%), followed by parental separation or divorce (27.63%; 95% CI, 27.02%-28.24%) and household substance abuse (27.56%; 95% CI, 27.00%-28.14%).
Conclusions and Relevance
This report demonstrates the burden of ACEs among the US adult population using the largest and most diverse sample to date. These findings highlight that childhood adversity is common across sociodemographic characteristics, but some individuals are at higher risk of experiencing ACEs than others. Although identifying and treating ACE exposure is important, prioritizing primary prevention of ACEs is critical to improve health and life outcomes throughout the lifespan and across generations.
This article describes the history of parental alienation syndrome [PAS] in American case law. Fifteen years of cases from 1987 through 2003 are described with illustrations from the public record. Special attention is given to the use and abuse of expert testimony from behavioral sciences professionals. Material cited by trial or appellate courts that was produced by PAS “detractors” is cited as a cross reference to the chapter, Parental Alienation Syndrome: Detractors and the Junk Science Vacuum, of this work, which analyzes three specific examples of articles written by these detractors.
Objective:
Adverse Childhood Experiences (ACEs) have consistently been associated with a range of negative psychological and physical outcomes in adulthood. Despite the strength of this association, no studies to date have investigated psychological processes that might underlie this relationship. The current study evaluated emotion regulation as a potential mediator between ACEs and three outcomes: PTSD symptoms, depression and poor physical health, all of which are frequently co-occurring among women with ACEs.
Method:
Mediational analyses were conducted with baseline data from a sample of 290 women enrolled in a clinical trial for PTSD. Emotion regulation was assessed with the Difficulties in Emotional Regulation Scale (DERS), PTSD with the Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5), depression with the Brief Symptom Inventory Depression subscale (BSI-D) and physical health with a shortened version of Medical Outcomes Study Short Form (SF-8).
Results:
Emotion regulation significantly mediated the relationship between ACEs and all three outcomes. The estimates of the standardized indirect effects of ACEs on the health outcomes as mediated through DERS scores were as follows: PTSD β = 0.1, p < .001; depression β = 0.16, p < .001; physical health β = 0.07, p = .002.
Conclusion:
Interventions that focus on improving emotion regulation skills might provide an efficient "transdiagnostic" treatment strategy for both psychological and physical health problems. The study successfully tested a mediational model that identified a common pathway influencing both mental and physical health symptoms. (PsycINFO Database Record
Background
Social support (SS) has been identified as an essential buffer to stressful life events. Consequently, there has been a surge in the evaluation of SS as a wellbeing indicator. The Multidimensional Perceived Social Support Scale (MSPSS) has evolved as one of the most extensively translated and validated social support outcome measures. Due to linguistic and cultural differences, there is need to test the psychometrics of the adapted versions. However, there is a paucity of systematic evidence of the psychometrics of adapted and translated versions of the MSPSS across settings. Objectives
To understand the psychometric properties of the MSPSS for non-English speaking populations by conducting a systematic review of studies that examine the psychometric properties of non-English versions of the MSPSS. Methods
We searched Africa-Wide Information, CINAHL, Medline and PsycINFO, for articles published in English on the translation and or validation of the MSPSS. Methodological quality and quality of psychometric properties of the retrieved translations were assessed using the COSMIN checklist and a validated quality assessment criterion, respectively. The two assessments were combined to produce the best level of evidence per language/translation. ResultsSeventy articles evaluating the MSPSS in 22 languages were retrieved. Most translations [16/22] were not rigorously translated (only solitary backward-forward translations were performed, reconciliation was poorly described, or were not pretested). There was poor evidence for structural validity, as confirmatory factor analysis was performed in only nine studies. Internal consistency was reported in all studies. Most attained a Cronbach’s alpha of at least 0.70 against a backdrop of fair methodological quality. There was poor evidence for construct validity. Conclusion
There is limited evidence supporting the psychometric robustness of the translated versions of the MSPSS, and given the variability, the individual psychometrics of a translation must be considered prior to use. Responsiveness, measurement error and cut-off values should also be assessed to increase the clinical utility and psychometric robustness of the translated versions of the MSPSS. Trial registrationPROSPERO - CRD42016052394.
Bei der induzierten Eltern-Kind-Entfremdung (Parental Alienation) handelt es sich um eine bestimmte Form von psychischer Kindesmisshandlung, die im DSM-5, dem aktuellen Diagnostic and Statistic Manual der American Psychiatric Association (APA) unter der Diagnoseziffer V 995.51 child psycholocical abuse verortet ist. Induzierte Eltern-Kind-Entfremdung, die nicht behandelt wird, kann zu traumatischen psycho-physischen Langzeitfolgen bei betroffenen Kindern führen. Dieser Tatsache wird in familiengerichtlichen Verfahren noch unzureichend Beachtung geschenkt. Der Artikel befasst sich zusammenfassend mit der Definition, der Symptomatik und den verschiedenen Schweregraden von Parental Alienation und beschreibt einige wichtige Entfremdungstechniken und mögliche psychosomatische und psychiatrische Folgen der induzierten Eltern-Kind-Entfremdung. Schließlich wird auf Präventions- und Interventionsprogramme hingewiesen, die inzwischen in einigen Ländern angewandt und evaluiert werden. Zwei Fallbeispiele aus der Praxis und ein ausführliches, internationales Literaturverzeichnis schließen die Arbeit ab.
BackgroundA dose-dependent effect of Adverse Childhood Experiences (ACE) on the course and severity of psychiatric disorders has been frequently reported. Recent evidence indicates additional impact of type and timing of distinct ACE on symptom severity experienced in adulthood, in support of stress-sensitive periods in (brain) development. The present study seeks to clarify the impact of ACE on symptoms that are often comorbid across various diagnostic groups: symptoms of posttraumatic stress disorder (PTSD), shutdown dissociation and depression. A key aim was to determine and compare the importance of dose-dependent versus type and timing specific prediction of ACE on symptom levels. Methods
Exposure to ten types of maltreatment up to age 18 were retrospectively assessed in N = 129 psychiatric inpatients using the Maltreatment and Abuse Chronology of Exposure (MACE). Symptoms of PTSD, shutdown dissociation, and depression were related to type and timing of ACE. The predictive power of peak types and timings was compared to that of global MACE measures of duration, multiplicity and overall severity. ResultsA dose-dependent effect (MACE duration, multiplicity and overall severity) on severity of all symptoms confirmed earlier findings. Conditioned random forest regression verified that PTSD symptoms were best predicted by overall ACE severity, whereas type and timing specific effects showed stronger prediction for symptoms of dissociation and depression. In particular, physical neglect at age 5 and emotional neglect at ages 4–5 were related to increased symptoms of dissociation, whereas the emotional neglect at age 8–9 enhanced symptoms of depression. Conclusion
In support of the sensitive period of exposure model, present results indicate augmented vulnerability by type x timing of ACE, in particular emphasizing pre-school (age 4–5) and pre-adolescent (8–9) periods as sensitive for the impact of physical and emotional neglect. PTSD, the most severe stress-related disorder, varies with the amount of adverse experiences irrespective of age of experience. Considering type and timing of ACE improves understanding of vulnerability, and should inform diagnostics of psychopathology like PTSD, dissociation and depression in adult psychiatric patients.
According to gender role theory, individuals who confirm expectations associated with their gender roles are rewarded and judged against these expectations when they deviate. Parental roles are strongly tied to gender, and there are very different expectations for behaviors of mothers and fathers. This study examined how mothers’ and fathers’ behaviors that support or discourage a positive relationship with the other parent are perceived in terms of their acceptability. Two-hundred twent-eight parents completed an online survey assessing perceptions of acceptability of negative (parental alienating) and positive coparenting behaviors. Results provided support for our hypothesis: Although parental alienating behaviors were rated unacceptable, they were more acceptable for mothers than fathers. Expectancy violation theory can explain why parental alienating behaviors are not viewed as negatively when mothers exhibit them than fathers.
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.
The Parental Alienation Syndrome, so named by Dr. Richard Gardner, is a distinctive family response to divorce in which the child becomes aligned with one parent and preoccupied with unjustified and/or exaggerated denigration of the other, target parent. In severe cases, the child's once love-bonded relationship with rejected/target parent is destroyed. Testimony on Parental Alienation Syndrome (PAS) in legal proceedings has sparked debate. This two-part article seeks to shed light on the debate by reviewing Gardner's work and that of others on PAS, integrating the concept of PAS with research on high conflict divorce and other related literature. The material is organized under topic headings such as parents who induce alienation, the child in PAS, the target/alienated parent, attorneys on PAS, and evaluation and intervention. Part II begins with the child in PAS. Case vignettes of moderate to severe PAS are presented in both parts, some of which illustrate the consequences for children and families when the system is successfully manipulated by the alienating parent, as well as some difficult but effective interventions implemented by the author, her husband Randy Rand, Ed.D., and other colleagues.
SYNOPSIS
Objective. The aims of this article were to test the measurement invariance of the Italian and American versions of the Adult Parental Acceptance–Rejection Questionnaire and to compare adults’ remembrances of parental acceptance–rejection across the two nations. Design. The Adult Parental Acceptance–Rejection Questionnaire was administered to 564 Italian adults (M = 23.04 years) and 509 U.S. American adults (M = 22.09 years), matched by gender and age. The measurement invariance of the Parental Acceptance–Rejection Questionnaire was first established by means of multi-group confirmatory factor analyses. Results. The Parental Acceptance–Rejection Questionnaire is fully invariant across the two cultures, and adults organize their remembrances of mothers’ and fathers’ parenting around the same four classes of behavior in both nations. Italian and American adults tend to remember their parents as having been quite loving, with Italian parents being remembered as slightly less warm and more hostile than American parents. Conclusions. The full invariance of the Parental Acceptance–Rejection Questionnaire across the two populations represents additional strong evidence for the universality of interpersonal acceptance–rejection theory. Measurement invariance also confirmed that the Adult Parental Acceptance–Rejection Questionnaire (short form) can be used to measure adult remembrances of parental acceptance–rejection across these two populations.
Children’s experiences and voices are underrepresented in academic literature and professional practice around domestic violence and abuse. The project “Understanding Agency and Resistance Strategies” (UNARS) addresses this absence, through direct engagement with children. We present an analysis from interviews with 21 children in the United Kingdom (12 girls and 9 boys, aged 8-18 years), about their experiences of domestic violence and abuse, and their responses to this violence. These interviews were analyzed using interpretive interactionism. Three themes from this analysis are presented: (a) “Children’s experiences of abusive control,” which explores children’s awareness of controlling behavior by the adult perpetrator, their experience of that control, and its impact on them; (b) “Constraint,” which explores how children experience the constraint associated with coercive control in situations of domestic violence; and (c) “Children as agents,” which explores children’s strategies for managing controlling behavior in their home and in family relationships. The article argues that, in situations where violence and abuse occur between adult intimate partners, children are significantly affected, and can be reasonably described as victims of abusive control. Recognizing children as direct victims of domestic violence and abuse would produce significant changes in the way professionals respond to them, by (a) recognizing children’s experience of the impact of domestic violence and abuse; (b) recognizing children’s agency, undermining the perception of them as passive “witnesses” or “collateral damage” in adult abusive encounters; and (c) strengthening professional responses to them as direct victims, not as passive witnesses to violence.
Available from: http://onlinelibrary.wiley.com/doi/10.1002/car.2422/abstract
This article begins to build knowledge of how non-violent coercive controlling behaviours can be central to children’s experiences of domestic violence. It considers how children can be harmed by, and resist, coercive controlling tactics perpetrated by their father/father-figure against their mother. Already, we know much about how women/mothers experience non-physical forms of domestic violence, including psychological/emotional/verbal and financial abuse, isolation, and monitoring of their activities. However, this knowledge has not yet reached most children and domestic violence research, which tends to focus on children’s exposure to physical violence. In this qualitative study, 30 participants from the UK, 15 mothers and 15 of their children (most aged 10-14) who had separated from domestic violence perpetrators, participated in semi-structured interviews. All participants were living in the community. Using the ‘Framework’ approach to thematically analyse the data, findings indicated that perpetrators’/fathers’ coercive control often prevented children from spending time with mothers and grandparents, visiting other children’s houses, and engaging in extra-curricular activities. These non-violent behaviours from perpetrators/fathers placed children in isolated, disempowering and constrained worlds which could hamper children’s resilience and development and contribute to emotional/behavioural problems. Implications for practice and the need to empower children in these circumstances are discussed.
This study examined associations between adverse childhood family experiences and adult physical health using data from 52,250 U.S. adults aged 18 to 64 from the 2009 to 2012 Behavioral Risk Factor Surveillance System. We found that experiencing childhood physical, verbal, or sexual abuse, witnessing parental domestic violence, experiencing parental divorce, and living with someone who was depressed, abused drugs or alcohol, or who had been incarcerated were associated with one or more of the following health outcomes: self-rated health, functional limitations, diabetes, and heart attack. Adult socioeconomic status and poor mental health and health behaviors significantly mediated several of these associations. The results of this study highlight the importance of family-based adverse childhood experiences on adult health outcomes and suggest that adult socioeconomic status (SES) and stress-related coping behaviors may be crucial links between trauma in the childhood home and adult health.
Seven hundred and thirty nine (739) Italian adults completed a survey about (A) the extent to which each parent engaged in parental alienation behaviors (B) the extent to which each parent engaged in psychological maltreatment and (C) a measure of parental bonding for each parent. Associations between these variables were examined for each parent and separately for participants whose parents remained married and those who divorced/separated. Results revealed that across the board, parental alienation was associated with psychological maltreatment over and above the effects of parental bonding. These data are understood in the context of a relationship-specific model of psychological maltreatment in which the child experiences parental acceptance of the self as distinct from parental acceptance of the child’s relationship with the other parent.
Epidemiological and biomedical evidence link adverse childhood experiences (ACEs) with health-harming behaviors and the development of non-communicable disease in adults. Investment in interventions to improve early life experiences requires empirical evidence on levels of childhood adversity and the proportion of HHBs potentially avoided should such adversity be addressed.
A nationally representative survey of English residents aged 18 to 69 (n = 3,885) was undertaken during the period April to July 2013. Individuals were categorized according to the number of ACEs experienced. Modeling identified the proportions of HHBs (early sexual initiation, unintended teenage pregnancy, smoking, binge drinking, drug use, violence victimization, violence perpetration, incarceration, poor diet, low levels of physical exercise) independently associated with ACEs at national population levels.
Almost half (47%) of individuals experienced at least one of the nine ACEs. Prevalence of childhood sexual, physical, and verbal abuse was 6.3%, 14.8%, and 18.2% respectively (population-adjusted). After correcting for sociodemographics, ACE counts predicted all HHBs, e.g. (0 versus 4+ ACEs, adjusted odds ratios (95% confidence intervals)): smoking 3.29 (2.54 to 4.27); violence perpetration 7.71 (4.90 to 12.14); unintended teenage pregnancy 5.86 (3.93 to 8.74). Modeling suggested that 11.9% of binge drinking, 13.6% of poor diet, 22.7% of smoking, 52.0% of violence perpetration, 58.7% of heroin/crack cocaine use, and 37.6% of unintended teenage pregnancy prevalence nationally could be attributed to ACEs.
Stable and protective childhoods are critical factors in the development of resilience to health-harming behaviors in England. Interventions to reduce ACEs are available and sustainable, with nurturing childhoods supporting the adoption of health-benefiting behaviors and ultimately the provision of positive childhood environments for future generations.
This study uses confirmatory factor analysis procedures to examine the factor structure of the mother and father versions of the Parental Acceptance-Rejection Questionnaire (PARQ) and their measurement invariance across ratings provided by 314 Australian adults and 509 adults in the United States. The adult version of the PARQ is a 60-item self-report instrument designed to measure adults’ perceptions of maternal and paternal acceptance-rejection during childhood. The questionnaire contains four scales measuring warmth/ affection, hostility/aggression, indifference/neglect, and undifferentiated rejection. Results of analyses support the proposed four-factor model. All but six items in the father version and all items in the mother version show invariance across the two national groups. Overall, the results indicate support for the factorial model of the PARQ, as well as measurement equivalence across the national groups tested.
This article examines the current state of research on parental alienation, which reveals that alienation is far more common and debilitating for children and parents than was previously believed. In extreme cases, one can make the argument that parental alienation is a serious form of emotional child abuse. Careful scrutiny of key elements of parental alienation in the research literature consistently identifies two core elements of child abuse: parental alienation as a significant form of harm to children that is attributable to human action. As a form of individual child abuse, parental alienation calls for a child protection response. As a form of collective abuse, parental alienation warrants fundamental reform of the family law system in the direction of shared parenting as the foundation of family law. There is an emerging scientific consensus on prevalence, effects, and professional recognition of parental alienation as a form of child abuse. In response, the authors discuss the need for research on effectiveness of parental alienation interventions, particularly in more extreme cases. This paper argues for more quantitative and qualitative research focused on four pillars of intervention at micro and macro levels, with specific recommendations for further study of child protection responses, reunification programs, and other therapeutic approaches.
The gender paradigm of intimate partner violence (IPV) research and theory has strongly influenced scholarly work on parental alienation. This paradigm has created a false “divide” between IPV and parental alienation scholars and professionals who work in these areas and has created unproductive and unnecessary conflict. This chapter highlights and draws parallels between research on IPV and parental alienating behaviors (PABs) to illustrate that they describe the same phenomenon. We also draw parallels in the research on how IPV and PABs affect the targets of these behaviors, their similarities in the patterns of abuse and motives of the perpetrator, and explore how children are affected. Finally, we detail how the gender paradigm has created controversies and the suppression of parental alienation and offers some solutions and suggestions on how this false divide can be bridged.
Background
Few studies examined the contributions of childhood adversities, intimate partner violence and social support to antenatal depression (AD). This study aims to 1) evaluate association of these psychosocial factors with AD symptoms in pregnancy; and 2) examine the mediating effect of social support on the relationship between psychosocial stressors and AD symptoms.
Methods
Participants were 120 pregnant women aged from 18 to 49 in less than 16 gestational weeks and attending at Antenatal Care Center at Khon Kaen hospital, Thailand. AD symptoms were assessed by the Edinburgh Postnatal Depression Scale (EPDS). Childhood adversities, intimate partner violence and social support were measured using the Adverse Childhood Experiences Questionnaire (ACE questionnaire), Abuse Assessment Screen (AAS), and Multidimensional Scale of Perceived Social Support (MSPSS).
Results
We found that the EPDS score was significantly and positively associated with adverse childhood experiences (ACEs) and negatively with social support. Partial Least Square analysis showed that 49.1% of the variance in the depressive subdomain of the EPDS score was predicted by ACEs, namely psychological and physical abuse and neglect, emotional or physical abuse by the partner, unplanned pregnancy, and no satisfaction with their relationship. The effects of adverse childhood experience due to neglect on the EDPS score was mediated by social support by friends.
Limitations
ACEs were assessed retrospectively and, therefore, may be susceptible to recall bias.
Conclusion
Prenatal depression scores are to a large extent predicted by psychological distress as indicated by early lifetime trauma, abuse by partner, relation satisfaction, and implications of unintended pregnancy.
The purpose of this study was to apply interdependence theory to understand the power dynamics in families affected by parental alienation. We hypothesized that the power dynamics between alienating and alienated parents are imbalanced such that this form of family violence (Harman et al., 2018) more closely resembles intimate terrorism than situational couple violence, where power dynamics are more similar between partners. We also hypothesized that shared parenting custodial arrangements would afford more power to targeted parents than unequal parenting plans and provide them with more opportunities for action. A qualitative analysis of transcripts from interviews with targeted parents of alienating behaviors (n = 79) using interdependence theory as a framework found support for our hypotheses: most situations described by parents were of asymmetric dependence, with power concentrated almost exclusively with the alienating parent, and/or were direct challenges made by the alienating parent to gain control over their children and the targeted parent. In addition, the proportion of situations in which asymmetries in power were described was highest when the alienating parent had primary or sole custody of the children. Discussion focuses on the need to better understand and consider the role of power in the assessment of parental alienation so that appropriate and effective interventions may be implemented to protect children and their family members.
Parental alienation occurs when a child aligns with one parent and unjustifiably rejects the other as a result of parental alienating behaviors. This paper provides an overview of current research and theory regarding the losses alienated children endure. Parental alienating behaviors alter the child’s beliefs, perceptions, and memories of the alienated parent, triggering a cascade of profound losses for the child. These losses include loss of individual self; childhood experiences; extended family; community; and activities and relationships essential for healthy development. Consequently, alienated children often experience ongoing and ambiguous losses and thereby suffer disenfranchised grief in isolation.
This study explored the experience of adults who had experienced parental alienation during childhood. Ten alienated adult children participated in 60 to 90-minute semi-structured interviews about their experience of parental alienation. Using Braun and Clarke (2006 Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101. https://doi.org/10.1191/1478088706qp063oa[Taylor & Francis Online] , [Google Scholar]) thematic analysis framework, seven themes were identified. Participants described experiencing abuse perpetrated by the alienating parent. They described experiencing anxiety, depression, low self-worth, guilt, attachment problems, difficulty in other relationships, and reduced or delayed educational and career attainment that they attributed to their experience of parental alienation. These results demonstrated that children’s exposure to parental alienation may have lifelong ramifications for their psychological well-being.
Background
Adverse childhood experiences (ACEs) can have severe detrimental effects on physical and mental health. This study aimed to present prevalence rates of ACEs amongst a mixed sample of hospital patients.
Methods
In- and outpatients at seven departments of the University Hospital of Innsbruck (Austria) participated in the study. They completed questionnaires regarding retrospective assessments of ACEs, physical and mental health and experience of domestic violence. The impact of ACEs on patients' health was evaluated by calculation of odds ratios (OR) in binary logistic regressions.
Results
A total of n = 2392 (74.3% of all approached patients) were included in the analyses. The results showed that 36.1% of them reported at least one form of ACEs, and 6.3% were polyvictimized (i.e. they reported ≥4 forms of ACEs). Most frequent forms of ACE were emotional abuse (18.3%), peer abuse (14.2%), and neglect (12.3%). ACEs were significantly associated with increased ORs for various physical diseases, mental health problems and domestic violence.
Conclusion
Retrospectively assessed ACEs are highly prevalent amongst hospital patients and exposure to high numbers of ACEs is associated with decreased physical and mental health. The identification of patients with symptoms following ACEs and referral to appropriate treatment is a crucial challenge for health-care professionals.
Fulltext Link: https://www.sciencedirect.com/science/article/pii/S0163834320300396
This study examined communication apprehension within parent–child relationships as a function of parental alienation and self-esteem. We posited that parental alienation in childhood was positively associated with parent–child communication apprehension in adulthood, and that self-esteem in adulthood mediated the association. Results from 211 college-aged students indicated that parental alienation from male and female caregivers in childhood was positively associated with communication apprehension with female caregivers in adulthood. In addition, parental alienation from male caregivers in childhood was positively associated with communication apprehension with male caregivers in adulthood. The findings also indicated a stronger positive relationship between parental alienation and parent–child communication apprehension when self-esteem was low rather than high.
This pilot study examined the psychometric properties of the Benevolent Childhood Experiences (BCEs) scale, a new instrument designed to assess positive early life experiences in adults with histories of childhood maltreatment and other adversities. A counterpart to the Adverse Childhood Experiences (ACEs) questionnaire, the BCEs was developed to be multiculturally-sensitive and applicable regardless of socioeconomic position, urban-rural background, or immigration status. Higher levels of BCEs were hypothesized to predict lower levels of psychopathology and stress beyond the effects of ACES in a sample of ethnically diverse, low-income pregnant women. BCEs were also expected to show adequate internal validity across racial/ethnic groups and test-retest stability from the prenatal to the postnatal period. Participants were 101 pregnant women (M=29.10years, SD=6.56, range=18-44; 37% Latina, 22% African-American, 20% White, 21% biracial/multiracial/other; 37% foreign-born, 26% Spanish-speaking) who completed the BCEs and ACEs scales; assessments of prenatal depression and post-traumatic stress disorder (PTSD) symptoms, perceived stress, and exposure to stressful life events (SLEs) during pregnancy; and demographic information. Higher levels of BCEs predicted less PTSD symptoms and SLEs, above and beyond ACEs. The BCEs showed excellent test-retest reliability, and mean levels were comparable across racial/ethnic and Spanish-English groups of women. Person-oriented analyses also showed that higher levels of BCEs offset the effects of ACEs on prenatal stress and psychopathology. The BCEs scale indexes promising promotive factors associated with lower trauma-related symptomatology and stress exposure during pregnancy and illuminates how favorable childhood experiences may counteract long-term effects of childhood adversity.
This study examined associations between exposure to parental alienation behaviors (PA) and anxiety and depression in a community sample of Italian adults. Data were examined by the gender of the alienating parent and the gender of the respondent/adult child. Five hundred nine adults were administered the Baker Strategy Questionnaire (BSQ), the State-Trait Anxiety Inventory (STAI-Y); and the Beck Depression Inventory (BDI-II). Results revealed that exposure to PA was associated with higher ratings of anxiety and depression. The data add to the growing body of knowledge regarding the long-term negative impact of exposure to parental alienation.
One hundred and nine college students completed an anonymous and confidential survey regarding their childhood exposure to parental alienation strategies by each parent as well as their own actions and attitudes toward each parent. Results revealed statistically significant associations between parental alienation behaviors and behaviors of an alienated child, even after controlling for the quality of parenting of the rejected parent. The findings are discussed in light of attachment theory, social learning theory, and family systems theory.
Several bodies of research, theory, and practice document that even maltreated children develop and maintain attachment relationships with their parents. While this attachment can confound clinicians, it can be understood from an evolutionary perspective: Attachments – even with abusive parents - increase the survival of the species by ensuring that dependent infants and children in danger will seek proximity and comfort from a caregiving adult. Despite the phenomenon being well documented, a missing piece from the literature is whether children – who have alternative caregiving options - will still express attachment to their maltreating parent. To address this question, 27 studies in which children currently in foster care were interviewed were coded for presence/absence of three expressions of attachment: (1) Yearning for the birth parents (2) Fear and anxiety due to separation from the birth parents and (3) Minimization of the maltreatment perpetrated against them by the birth family. We also asked whether, despite the presence of attachment, maltreated children would express relief upon removal from the home of the birth parent. Most of the studies reported that at least some children expressed these four related beliefs, providing important insight for clinicians working with maltreated children.
Moving beyond the narrow clinical perspective sometimes applied to viewing the emotional and developmental risks to battered children, The Batterer as Parent: Addressing the Impact of Domestic Violence on Family Dynamics, Second Edition offers a view that takes into account the complex ways in which a batterer’s abusive and controlling behaviors are woven into the fabric of daily life. This book is a guide for therapists, child protective workers, family and juvenile court personnel, and other human service providers in addressing the complex impact that batterers—specifically, male batterers of a domestic partner when there are children in the household—have on family functioning. In addition to providing an understanding of batterers as parents and family members, the book also supplies clearly delineated approaches to such practice issues as assessing risk to children (including perpetrating incest), parenting issues in child custody and visitation evaluation, and impact on children's therapeutic process and family functioning in child protective practice.
Context Suicide is a leading cause of death in the United States, but identifying
persons at risk is difficult. Thus, the US surgeon general has made suicide
prevention a national priority. An expanding body of research suggests that
childhood trauma and adverse experiences can lead to a variety of negative
health outcomes, including attempted suicide among adolescents and adults.Objective To examine the relationship between the risk of suicide attempts and
adverse childhood experiences and the number of such experiences (adverse
childhood experiences [ACE] score).Design, Setting, and Participants A retrospective cohort study of 17 337 adult health maintenance
organization members (54% female; mean [SD] age, 57 [15.3] years) who attended
a primary care clinic in San Diego, Calif, within a 3-year period (1995-1997)
and completed a survey about childhood abuse and household dysfunction, suicide
attempts (including age at first attempt), and multiple other health-related
issues.Main Outcome Measure Self-reported suicide attempts, compared by number of adverse childhood
experiences, including emotional, physical, and sexual abuse; household substance
abuse, mental illness, and incarceration; and parental domestic violence,
separation, or divorce.Results The lifetime prevalence of having at least 1 suicide attempt was 3.8%.
Adverse childhood experiences in any category increased the risk of attempted
suicide 2- to 5-fold. The ACE score had a strong, graded relationship to attempted
suicide during childhood/adolescence and adulthood (P<.001).
Compared with persons with no such experiences (prevalence of attempted suicide,
1.1%), the adjusted odds ratio of ever attempting suicide among persons with
7 or more experiences (35.2%) was 31.1 (95% confidence interval, 20.6-47.1).
Adjustment for illicit drug use, depressed affect, and self-reported alcoholism
reduced the strength of the relationship between the ACE score and suicide
attempts, suggesting partial mediation of the adverse childhood experience–suicide
attempt relationship by these factors. The population-attributable risk fractions
for 1 or more experiences were 67%, 64%, and 80% for lifetime, adult, and
childhood/adolescent suicide attempts, respectively.Conclusions A powerful graded relationship exists between adverse childhood experiences
and risk of attempted suicide throughout the life span. Alcoholism, depressed
affect, and illicit drug use, which are strongly associated with such experiences,
appear to partially mediate this relationship. Because estimates of the attributable
risk fraction caused by these experiences were large, prevention of these
experiences and the treatment of persons affected by them may lead to progress
in suicide prevention.
Direct and indirect effects of exposure to 19 parental alienation strategies in 118 adult children of divorce were examined via a confidential and anonymous computer survey. We investigated the nature and prevalence of alienation strategies to which this sample was exposed as well as associations between exposure and self-esteem and self-sufficiency. In turn, we examined and found associations between self-esteem and higher rates of depression and insecure attachment styles and a trend for an association with alcohol abuse. All effects were found even after controlling for histories of physical abuse, sexual abuse, and psychological maltreatment. These findings add to the growing body of evidence regarding the long-term consequences of experiencing parental alienation and indicate that in general, exposure to more alienation behaviors leads to more negative outcomes in children of divorce, which can be seen across the life span.
This qualitative study concerns the life paths and lived experiences of 6 adults who have been alienated from a parent in the past. The results suggest several hypotheses concerning the factors that might place children at risk of being alienated from a parent. The presence of postseparation conflict and, in some cases, domestic violence, as well as the triangulation of the child appear to be elements that favor the emergence of parental alienation. Moreover, this study supports a multifactorial explanation of parental alienation. In the scope of lived experience, respondents associated alienation with difficulties at school, internal and external behavior problems, and a search for identity after reaching adulthood. Finally, overcoming the state of alienation involves issues surrounding the establishment of boundaries with the alienating parent and the rebuilding of a relationship with the alienated parent.
The parental alienation syndrome is commonly seen in highly contested child-custody disputes. The author has dcscribed three types: mild, moderate, and severe-each of which requires special approaches by both legal and mental health professionals. The purpose of this article is to correct some misinterpretations of the author's recommendations as well as to add some recently developed refinements. Particular focus is given to the transitional-site program that can be extremely useful for dealing with the scvcre type of, parental alienation syndrome. Dealing properly with parental-alienation— syndrome families requires close cooperation between legal and mcntal health professionals. Without such cooperation therapeutic approaches are not likely to succeed. With such cooperation the treatment, in many cases, is likely to be highly effective.