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Parental estrangement is not a mental disorder.

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Parental estrangement is not a mental disorder; it refers to a child’s rejection of a parent for a good reason. For example, a child might refuse to have a relationship with a parent who previously was abusive or neglectful or who abandoned the family. If one of the parents perpetrated domestic violence within the family, it is understandable that the child might avoid parenting time with that person. It is not a mental disorder to reject a relationship and avoid spending time with an abusive individual; it is normal for a child to behave in that manner.

Although parental estrangement is not a mental disorder, there are terms in DSM-5 that can be used to identify children who experience this condition. In DSM-5 abuse and neglect are found in the section “Other Conditions That May Be a Focus of Clinical Attention,” which are referred to as “conditions and problems,” rather than “mental disorders.” The section includes personal history of physical abuse in childhood and personal history of neglect in childhood. When a clinical or forensic practitioner determines that a child exhibits parental estrangement, one of those terms may be used to establish the appropriate diagnosis.

Parental separation and divorce are common features of contemporary society. About 25% of children in the US live with only one parent.1 The parents may have been married and then separated or divorced; perhaps the parents were never married and never lived together; or perhaps the parents were never married, lived together, and later separated. 

Many children are able to deal with their parents’ divorce in a reasonably constructive manner because of their inherent resiliency; the parents’ ability and willingness to communicate and collaborate in a healthy manner; and the support of extended family members and others in the community. On the other hand, children may be battered and injured by factors that are directly or indirectly associated with the divorce: reduced parenting time with one or both parents; financial instability; relocation, which involves changing schools and losing friends; and the inconvenience of traveling between the parents’ homes. Both clinicians and forensic evaluators know that the single most important factor that harms children of divorce is continual conflict between the parents.2 Children are damaged when their parents fight in front of them, over them, and through them.

TABLE. Symptoms of parental alienation
TABLE. Symptoms of parental alienation
Mental health practitioners (MHPs) see and hear about children of divorce in a variety of contexts. The MHP may be the therapist for the child or one of the parents. The child may present to an emergency department in a crisis situation. The child may be an observer or victim of domestic violence. In the forensic context, the MHP may conduct a child custody evaluation or participate in an investigation of allegations of child maltreatment. Clinical and forensic practitioners may identify a number of mental conditions in children who experience high-conflict divorce, which are described in this article and assigned appropriate terminology in DSM-5.
- See more at: http://www.psychiatrictimes.com/special-reports/children-high-conflict-divorce-face-many-challenges#sthash.9o1W9zpI.dpuf

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"So live your life that the fear of death can never enter your heart. Trouble no one about their religion; respect others in their view, and demand that they respect yours. Love your life, perfect your life, beautify all things in your life. Seek to make your life long and its purpose in the service of your people. Prepare a noble death song for the day when you go over the great divide. Always give a word or a sign of salute when meeting or passing a friend, even a stranger, when in a lonely place. Show respect to all people and grovel to none. When you arise in the morning give thanks for the food and for the joy of living. If you see no reason for giving thanks, the fault lies only in yourself. Abuse no one and no thing, for abuse turns the wise ones to fools and robs the spirit of its vision. When it comes your time to die, be not like those whose hearts are filled with fear of death, so that when their time comes they weep and pray for a little more time to live their lives over again in a different way. Sing your death song and die like a hero going home." (Tecumseh).

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