Parental Alienation Syndrome is a Legitimate Syndrome
The purpose of this article is to present scientific evidence to challenge the ongoing, unscientific claims about “parental alienation.”
OUR GOAL
- Dispel the argument that Parental Alienation Syndrome (PAS) is not a real syndrome, and that Parental Alienation (PA) isn’t a legitimate family issue.
- Confirm that Gardner’s eight symptoms of alienation in children fit the DSM criteria for a syndrome, which helps diagnose various family-related problems and mental health disorders in the DSM-5.
In this article, we’ll show how the DSM syndrome definition, often used to dismiss PAS as illegitimate, has been misrepresented. This misrepresentation leads to flawed conclusions about PAS’s validity.
Syndrome Definition in the Psychiatric Community (PAS)
According to the National Institute of Health and the National Library of Medicine: “A syndrome is a recognizable complex of symptoms and physical findings that indicate a specific condition for which a direct cause is not necessarily understood.”
Syndrome Definition in the DSM-5
The DSM-5 defines syndrome as a grouping of signs and symptoms, based on their frequent co-occurrence that may suggest a common underlying pathogenesis, course, familial pattern, or treatment selection. (DSM-5 p.830)
Gardner’s Eight Symptoms and DSM Criteria
Gardner’s eight symptoms not only fit the actual DSM syndrome definition but are also highly specific and sensitive for identifying alienated children. These symptoms help determine relevant DSM-5 family problems and mental disorders in individual cases.
Parental Alienation (PA) is not a new idea—it’s a real family phenomenon dating back to at least the 1950s, when the Family Therapy Movement began. In fact, the concept of “triangulation,” which was used in the 1950s to describe family dynamics, is essentially what we now refer to as parental alienation.
Historical and Clinical Roots of Parental Alienation
Parental Alienation is not a recent phenomenon but a documented family dynamic dating back to the 1950s Family Therapy Movement. The term “triangulation,” used to describe these dynamics, closely parallels what we now call parental alienation.

The Harm of Dismissing PAS and PA
Children are being harmed when unscientific claims lead to dismissing PAS and PA in courtrooms and therapy. These claims suggest PAS and PA don’t have psychiatric acceptance.
To protect children, courts must take parental alienation allegations as seriously as they do domestic violence claims, ensuring that all types of abuse—including psychological manipulation—are properly addressed and prevented.
Unscientific Claims Against PAS
For over 20 years, critics have labeled PAS as “junk science” and dismissed PA as a “useless” model for diagnosing and treating alienation. They argue that both PAS and PA should be excluded from courts and therapy sessions.
Despite these criticisms, the debate about alienation has sparked more discussion than most other clinical conditions referenced in the DSM.
Over the past 20 years, alienation has been rigorously debated in legal and clinical journals, peer-reviewed studies, professional conferences, and in custody cases worldwide. (Bernet, 2010; Joshi, 2021; Lorandos & Bernet, 2020; Lorandos, 2020)
Challenging the Unscientific Claims
There are strong arguments against these unscientific claims. In over 40 years since Dr. Richard Gardner identified the eight symptoms of PAS, no peer-reviewed study has shown that these symptoms appear in other groups of children, such as non-alienated children of divorce or abused children.
There’s also been no research disproving Gardner’s symptoms. If the symptoms were inaccurate, evidence against them would have surfaced. Instead, research confirms that these symptoms reliably identify alienated children.
Supporting Evidence
Here are just a few examples of the wide body of research supporting Gardner’s findings: Baker, 2020; Baker, Burkhard, Kelly, 2012; Baker & Darnall, 2006; Bernet, Gregory, Reay, Rohner, 2018; Clawar & Rivlin, 2017; Fidler & Ward, 2017; Gottlieb, 2012; Lorandos, Bernet, Sauber, 2013; Warshak, 2010.
Statistics Proving Gardner’s Eight Symptoms
Our evidence-based practice shows how sensitive and specific Gardner’s eight symptoms are for identifying alienated children. In a sample of 3,300 non-alienated children of divorce, none exhibited any of the eight symptoms. Meanwhile, 1,208 alienated children consistently displayed most, if not all, of the symptoms.
In 3,600 cases of abused or neglected children, very few showed any of the symptoms, and none exhibited more than one. This proves how accurate Gardner’s symptoms are for distinguishing alienation from other family issues.
In the 2019 study, The Assessment of the Attitudes and Behaviors about Physically Abused Children by Baker, Miller, Bernet, and Abadayo, the researchers collected data from 300 child protection workers, therapists, and social workers who worked with 17,500 physically abused children.
The study found that Gardner’s eight symptoms are highly specific for identifying alienated children. The researchers noted:
“For the most part, abused children didn’t behave in rude or unkind ways toward the caretaker, refuse contact with the parent, express weak reasons for their anger, idolize the other parent, or exhibit other key symptoms of alienation.”

Dr. Miller analyzed the data further and found that the symptoms have less than a 1% error rate, which means they are over 99% accurate in identifying an alienated child.
What Informed This Article
The history of parental alienation in psychiatric practice, dating back to the Family Therapy Movement of the 1950s.
The scientific application of Gardner’s eight symptoms in real-life cases, which helps determine the best treatment plan.
The Meritless Anti-Syndrome Definition by Kelly and Johnston
In their article The Alienated Child – A Reformulation of Parental Alienation Syndrome (July 2001, Family Court Review), Joan Kelly and Janet Johnston reinterpret the DSM’s definition of Parental Alienation Syndrome (PAS), resulting in a significantly distorted version of the actual criteria.
Their redefinition fundamentally changes the standards for what they say qualifies as a syndrome.
This blatant misrepresentation forms the basis of their anti-syndrome argument against PAS.
Kelly and Johnston argue that since PAS lacks a “commonly recognized or empirically verified pathogenesis, course, familial pattern, or treatment selection,” it cannot be officially classified as a diagnostic syndrome by the American Psychiatric Association.
Specifically, they suggest that the criteria following the word “may” are mandatory requirements for a syndrome, rather than optional. If their distorted definition were applied in medicine, countless conditions that are now recognized as syndromes—such as AIDS and COVID-19—would not have initially qualified.
Since the publication of Kelly and Johnston’s 2001 article, a few authors have uncritically adopted and promoted their distorted definition, without questioning or challenging their anti-syndrome perspective.
As a result, this flawed definition has influenced additional “scholarly” articles, which are mistakenly regarded as authoritative, despite being based on the same misrepresentation found in Kelly and Johnston’s work.
Evaluating the Credentials of PAS Critics
When considering critics like Kelly (a clinical child psychologist) and Johnston (a sociologist), it’s important to evaluate their qualifications in comparison to Dr. Richard Gardner’s.
Gardner was Board Certified in psychiatry, child psychiatry, and forensic psychiatry and served as a Clinical Professor at Columbia University Medical School. Evaluating the qualifications of critics ensures that their critiques are credible and informed.
Gardner’s Definition of PAS
Dr. Richard Gardner was the first to publish on the eight recurring symptoms he observed in children involved in high-conflict custody battles, where children unjustifiably rejected one parent. He coined the term “Parental Alienation Syndrome” (PAS) to describe this condition.
PAS arises in child custody disputes when a child launches an unjustified campaign against one parent, driven by programming from the other parent (also called brainwashing) combined with the child’s own negative contributions to the vilification of the target parent.
PAS does not apply in cases of actual abuse or neglect.
When true parental abuse and/or neglect is present the child’s rejection may be justified, and so the parental alienation syndrome explanation for the child’s hostility is not applicable.
Gardner also emphasized that a case cannot be classified as alienation if the rejected parent has been abusive or neglectful. The child’s hostility is then a response to real harm, not parental alienation.
Although Gardner initially believed that alienating parents were more often mothers, he later revised this view, recognizing that both mothers and fathers engage in alienating behaviors equally.
The Alliance Between the Alienating Parent and the Child
According to Gardner (1998), one of the main reasons a child sides with the alienating parent is because their emotional bond with that parent is stronger than with the rejected parent. The child’s rejection of the other parent is part of an effort to protect and maintain their relationship with the alienating parent.

The alienating parent, in turn, uses various tactics to strengthen this bond and keep the child on their side.
Gardner also identified eight common behaviors in alienated children, which he referred to as “weapons” that the child uses to support the alienating parent’s position. The alienating parent often encourages these behaviors and even welcomes the child’s exaggerated or irrational complaints about the other parent.
The child’s desire to keep their connection with the alienating parent often fuels these behaviors.
Another factor that Gardner suggested plays a role in the development of parental alienation is something called “identification with the aggressor.” In this case, the child aligns with the alienating parent, who may be aggressive or angry, out of fear.
The child feels that by siding with the alienating parent, they can protect themselves from becoming the target of the parent’s hostility.
Conclusion
This article has presented scientific evidence to challenge the unscientific claims about Parental Alienation (PA) and Parental Alienation Syndrome (PAS). By affirming that Gardner’s eight symptoms meet the DSM criteria for a syndrome, we’ve shown that both PA and PAS are real and serious family dynamics.
Critics’ misrepresentation of the DSM syndrome definition has led to the unjustified dismissal of PAS. However, the scientific evidence supports the legitimacy of PAS and its importance in addressing the psychological harm inflicted on children.
Proper recognition of these issues is essential to ensuring accurate diagnoses and effective interventions in cases of parental alienation.
*In Dedication to Steven G. Miller, MD, our friend, mentor, and colleague.