Parental alienation syndrome or alienating parental relational behaviour disorder: a critical overview

Sindrome da alienazione parentale o disturbo del comportamento relazionale genitoriale di tipo alienante: un’overview critica

A. Siracusano, Y. Barone, G. Lisi, C. Niolu

Dipartimento di Medicina dei Sistemi, Università di Roma Tor Vergata, UOC di Psichiatria e psicologia clinica, Policlinico Tor Vergata, Roma, Italia



Parental alienation is very common in conflictual separations and is a serious problem in most parts of the world. In 50% of separations and in one-third of divorces a child under 18 is involved. One of the major problems in these cases is when children reject a parent after divorce. In conflictual separations a real psychopathology, defined as parental alienation syndrome (PAS) in 1985, can develop. In recent years, a growing interest in this syndrome has been seen in the international scientific community: several studies have been carried out and the necessity for a more accurate definition of PAS has been considered beneficial because courts, scientific and clinical practice are interested in this syndrome. In order to understand parental alienation better, our investigation aims to identify which findings in published studies may be useful to clinical practice involving both parents and children.


Our study systematically reviewed all publications in the MEDLINE/PubMed database searching for the terms “parental alienation”, “parental alienation syndrome”, or “parental alienation disease” as keywords. We included studies and books that were published online between 1985 and 2015, included original data or reviews and involved assessment and/or diagnosis and/or treatment of PAS. This assessment will reveal strengths and weaknesses in the current PAS literature; moreover, we present suggestions for improving the refinement of the literature.


A total of 28 articles and books were appropriate for this review. The studies included raised many fundamental questions such as the scientific validity of PAS, the proposal of specific diagnostic criteria and the importance of an accurate diagnosis. Findings from studies that met inclusion criteria in our review are presented, suggesting new clinical perspectives and raising new questions concerning assessment and treatment.


The theme of parental alienation is currently the subject of important research and debate. Based on the research carried out, we could state that parent alienation does not correspond to a “syndrome” or a specific individual psychic “disorder”. It can better defined as a dysfunctional family relation model determined by the excluding or “alienating” parent, the excluded or “alienated” parent and the child, each member of this triad with his/her own responsibilities and contribution. The explanation of this disorder has its own validity, but thorough research to clarify its features, (e.g. duration and intensity of symptoms) should be conducted, otherwise it could be instrumentally used in litigations. Further systematic and large-scale studies of parental alienation are needed that take into account the issues discussed and proper objective diagnostic criteria should be defined for scrupulous diagnosis and valid treatment.

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