Anglų kalba ( vertimas ruošiamas).

Parental alienation is not a free-standing diagnosis in either DSM-5-TR or ICD-11. However, these two diagnostic systems are consistent in that both of them allow for the coding of cases involving parental alienation. In the DSM-5-TR, parental alienation may be identified as parent–child relational problem (Z62.820); in the ICD-11, parental alienation may be identified as caregiver–child relationship problem (QE52.0).
Alternative Diagnoses for Cases of Parental Alienation
The recent communications from the DSM-5-TR Steering Committee focused on the mental condition PCRP. Several DSM-5-TR diagnoses may be appropriate to use in cases of parental alienation, depending on the details of the clinical presentation and the focus of clinical attention. For example:
Parent–child relational problem (PCRP) (Z62.820). The definition of this mental condition includes:
“…negative attributions of the other’s intentions, hostility toward the other, and unwarranted feelings of estrangement.” The diagnosis of PCRP would be appropriate if the focus of clinical attention is on the relationship between the alienated child and the alienated parent.
Child affected by parental relationship distress (CAPRD) (Z62.898). The definition of CAPRD includes
“…negative effects of parental relationship discord (e.g., high levels of conflict, distress, or disparagement) on a child in the family.” The diagnosis of CAPRD would be appropriate if the focus of clinical attention is on the mental condition of the alienated child (Bernet, Wamboldt, & Narrow, 2016).
Child psychological abuse (T74.32XA). The definition for this mental condition includes: “…harming/abandoning people or things that the child cares about.” The diagnosis of child psychological abuse can be given to the adult perpetrator of maltreatment or the child victim of maltreatment. This diagnosis would be appropriate if the focus of clinical attention is on the activities of an abusive, alienating parent (Kruk, 2018).
Delusional symptoms in the context of relationship with an individual with prominent delusions (F28).
This is DSM-5-TR terminology for the mental disorder that previously was called folie à deux and shared psychotic disorder. In severe cases of parental alienation, the underlying explanation might be a delusional disorder in the favored parent. In such a case, it would be appropriate to diagnose the child with delusional symptoms in the context of relationship with an individual with prominent delusions (Tucker & Cornwell, 1977).
Factitious disorder imposed on another (F68.A). This is DSM-5-TR terminology for the mental disorder that previously was called factitious disorder by proxy. In some cases of parental alienation, the alienating parent might falsify physical or psychological signs or symptoms in order cause the child to appear ill, injured, or abused. In such a case, it would be appropriate to diagnose the perpetrator (not the child) with factitious disorder imposed on another (Bütz, 2020).

Identity disturbance due to prolonged and intense coercive persuasion (F44.89). In some cases of parental alienation, the child who has been subjected to intense coercive persuasion (e.g.,indoctrination, thought reform) may present with prolonged changes in, or conscious questioning of, their identity. In such a case, it would be appropriate to diagnose the child with identity disturbance due to prolonged and intense coercive persuasion.
Conclusions
Although the actual words “parental alienation” are not found in the DSM-5-TR, there are many ways for clinicians to identify a child or family member who are experiencing the pathological triadic relationship that characterizes this mental condition. It may be appropriate to use multiple diagnoses for the family members depending on the focus of clinical attention. For example, a parent manifesting a severe level of alienating behaviors might be identified as being a perpetrator of child psychological abuse, while the maltreated child might be identified as having CAPRD. The complete definitions and descriptions of these conditions are found in the current edition of DSM-5-TR. Practitioners evaluating a child or a family that might be experiencing parental alienation are advised to: collect clinical information from multiple sources; consider all the possible underlying causes of contact refusal or parent–child contact problems; and carefully apply the criteria for the pertinent mental disorders and conditions.

References
Bernet W, Wamboldt MZ, & Narrow WE (2016). Child affected by parental relationship distress. Journal of
the American Academy of Child and Adolescent Psychiatry, 55(7), 571– 579.
Bütz MR (2020). Parental Alienation and Factitious Disorder by Proxy Beyond DSM-5: Interrelated Multidimensional Diagnoses. New York, NY: Routledge.
Kruk E (2018). Parental alienation as a form of emotional child abuse: Current state of knowledge and future
directions for research. Family Science Review, 22(4), 141–164.
Tucker LS & Cornwall TP (1977). Mother-son folie à deux: A case of attempted patricide. American Journal
of Psychiatry, 134(10), 1146–1147.

Parental Alienation Study Group
www.pasg.info