Parental alienation syndrome (abbreviated as PAS) is a term coined by child psychiatrist Richard A. Gardner, and introduced in his 1985 paper, to describe a suite of distinctive behaviors consistently shown by children who have been psychologically manipulated into showing unwarranted fear, disrespect or hostility towards a parent and/or other family members - typically, by the other parent and during child custody disputes. An early proponent of parental alienation syndrome argued that parental alienation involves a focus on the parent, while parental alienation syndrome also involves hatred and vilification of a targeted parent by the child.

Parental alienation syndrome is not recognized as a disorder by the medical or legal communities and Gardner's theory and related research have been extensively criticized by legal and mental health scholars for lacking scientific validity and reliability. However, the separate but related concept of parental alienation, the estrangement of a child from a parent, is recognized as a dynamic in some divorcing families.

The admissibility of PAS has been rejected by an expert review panel and the Court of Appeal of England and Wales in the United Kingdom and Canada's Department of Justice recommends against its use. PAS has been mentioned in some family court cases in the United States. Gardner portrayed PAS as well accepted by the judiciary and having set a variety of precedents, but legal analysis of the actual cases indicates that as of 2006 this claim was incorrect.

No professional association has recognized PAS as a relevant medical syndrome or mental disorder, and it is not listed in the International Statistical Classification of Diseases and Related Health Problems of the WHO or in the American Psychiatric Association's "Diagnostic and Statistical Manual of Mental Disorders" (DSM).

Gardner described PAS as a preoccupation by the child with criticism and deprecation of a parent. Gardner stated that PAS occurs when, in the context of child custody disputes, one parent deliberately or unconsciously attempts to alienate a child from the other parent. According to Gardner, PAS is characterized by a cluster of eight symptoms that appear in the child. These include a campaign of denigration and hatred against the targeted parent; weak, absurd, or frivolous rationalizations for this deprecation and hatred; lack of the usual ambivalence about the targeted parent; strong assertions that the decision to reject the parent is theirs alone (the "independent-thinker phenomenon"); reflexive support of the favored parent in the conflict; lack of guilt over the treatment of the alienated parent; use of borrowed scenarios and phrases from the alienating parent; and the denigration not just of the targeted parent but also to that parent's extended family and friends. Despite frequent citations of these factors in scientific literature, "the value ascribed to these factors has not been explored with professionals in the field".

Gardner and others have divided PAS into mild, moderate and severe levels. The number and severity of the eight symptoms displayed increase through the different levels. The recommendations for management differ according to the severity level of the child's symptoms. While a diagnosis of PAS is made based on the child's symptoms, Gardner stated that any change in custody should be based primarily on the symptom level of the alienating parent. In mild cases, there is some parental programming against the targeted parent, but little or no disruption of visitation, and Gardner did not recommend court-ordered visitation. In moderate cases, there is more parental programming and greater resistance to visits with the targeted parent. Gardner recommended that primary custody remain with the programming parent if the brainwashing was expected to be discontinued, but if not, that custody should be transferred to the targeted parent. In addition, therapy with the child to stop alienation and remediate the damaged relationship with the targeted parent was recommended. In severe cases, children display most or all of the 8 symptoms, and will refuse steadfastly to visit the targeted parent, including threatening to run away or commit suicide if the visitation is forced. Gardner recommended that the child be removed from the alienating parent's home into a transition home before moving into the home of the targeted parent. In addition, therapy for the child is recommended. Gardner's proposed intervention for moderate and severe PAS, including court-ordered transfer to the alienated parent, fines, house arrest, incarceration, have been critiqued for their punitive nature towards the alienating parent and alienated child, and for the risk of abuse of power and violation of their civil rights. With time, Gardner revised his views and expressed less support for the most aggressive management strategies.

Richard Weaver, in his work "Ideas Have Consequences", introduced the term “spoiled child psychology” in 1948. In 1989, Bruce McIntosh coined the term the "spoiled child syndrome". The syndrome is characterized by "excessive, self-centered, and immature behavior". It includes lack of consideration for other people, recurrent temper tantrums, an inability to handle the delay of gratification, demands for having one's own way, obstructiveness, and manipulation to get their way. McIntosh attributed the syndrome to "the failure of parents to enforce consistent, age-appropriate limits", but others, such as Aylward, note that temperament is probably a contributory factor. It is important to note that the temper tantrums are "recurrent". McIntosh observes that "many of the problem behaviors that cause parental concern are unrelated to spoiling as properly understood". Children may have occasional temper tantrums without them falling under the umbrella of "spoiled". Extreme cases of spoiled child syndrome, in contrast, will involve "frequent" temper tantrums, physical aggression, defiance, destructive behavior, and refusal to comply with even the simple demands of daily tasks. This can be similar to the profile of children diagnosed with Pathological Demand Avoidance, which is part of the autism spectrum.

Children with underlying medical or mental health problems may exhibit some of the symptoms. Indeed, where the difficulties are not predicated in the parental-child nexus, many loving parents may be judged as "spoiling" instead of affirmed. Speech or hearing disorders, and attention deficit disorder, may lead to children's failing to understand the limits set by parents. Children who have recently experienced a stressful event, such as the separation of the parents (divorce) or the birth or death of a close family relative, may also exhibit some or all of the symptoms. Children of parents who themselves have psychiatric disorders may manifest some of the symptoms, because the parents behave erratically, sometimes failing to perceive their children's behavior correctly, and thus fail to properly or consistently define limits of normal behavior for them.

Counterdependency is the state of refusal of attachment, the denial of personal need and dependency, and may extend to the omnipotence and refusal of dialogue found in destructive narcissism, for example.

While narcissists are common, malignant narcissists are less common. A notable difference between the two is the feature of sadism, or the gratuitous enjoyment of the pain of others. A narcissist will deliberately damage other people in pursuit of their own selfish desires, but may regret and will in some circumstances show remorse for doing so, while a malignant narcissist will harm others and enjoy doing so, showing little empathy or regret for the damage they have caused.

Malignant narcissism is a psychological syndrome comprising an extreme mix of narcissism, antisocial behavior, aggression, and sadism. Often grandiose, and always ready to raise hostility levels, the malignant narcissist undermines organizations in which they are involved, and dehumanizes the people with whom they associate.

Malignant narcissism is a hypothetical, experimental diagnostic category. Narcissistic personality disorder is found in the "Diagnostic and Statistical Manual of Mental Disorders" (DSM-IV-TR), while malignant narcissism is not. As a hypothetical syndrome, malignant narcissism could include aspects of narcissistic personality disorder as well as paranoia. The importance of malignant narcissism and of projection as a defense mechanism has been confirmed in paranoia, as well as "the patient's vulnerability to malignant narcissistic regression".

Perfectionism, in psychology, is a personality trait characterized by a person's striving for flawlessness and setting high performance standards, accompanied by critical self-evaluations and concerns regarding others' evaluations. It is best conceptualized as a multidimensional characteristic, as psychologists agree that there are many positive and negative aspects. In its maladaptive form, perfectionism drives people to attempt to achieve an unattainable ideal, while their adaptive perfectionism can sometimes motivate them to reach their goals. In the end, they derive pleasure from doing so. When perfectionists do not reach their goals, they often fall into depression.

A cuckold is the husband of an adulterous wife. In evolutionary biology, the term is also applied to males who are unwittingly investing parental effort in offspring that are not genetically their own.

Pyromania is an impulse control disorder in which individuals repeatedly fail to resist impulses to deliberately start fires, in order to relieve tension or for instant gratification. The term pyromania comes from the Greek word πῦρ ("pyr", fire). Pyromania is distinct from arson, the deliberate setting of fires for personal, monetary or political gain. Pyromaniacs start fires to induce euphoria, and often fixate on institutions of fire control like fire houses and firemen. Pyromania is a type of impulse control disorder, along with kleptomania, intermittent explosive disorder and others.

Perfectionists strain compulsively and unceasingly toward unobtainable goals, and measure their self-worth by productivity and accomplishment. Pressuring oneself to achieve unrealistic goals inevitably sets the person up for disappointment. Perfectionists tend to be harsh critics of themselves when they fail to meet their standards.

Individual factors that can lead to pyromania mainly deal with personal issues in someone's life. This category includes adolescents who have committed crimes in the past. For example, 19% of adolescents suffering from pyromania have been charged with vandalism and 18% are non-violent sexual offenders. Other causes may include the seeking of attention from authorities or parents and resolving social issues such as bullying or lack of friends or siblings. Another cause may be that the patient is subconsciously seeking revenge for something that has occurred in the past. Individuals with pyromania have also been prominent in having antisocial traits. These include truancy, running away from home, and delinquency. Child and adolescent cases are usually associated with ADHD or adjustment disorders.

The roots of counterdependency can be found in the age-appropriate negativism of two-year-olds and teens, where it serves the temporary purpose of distancing one from the parental figure[s]. As Selma Fraiberg put it, the two-year-old "says 'no' with splendid authority to almost any question addressed to him...as if he establishes his independence, his separateness from his mother, by being opposite". Where the mother has difficulty accepting the child's need for active distancing, the child may remain stuck in the counterdependent phase of development because of developmental trauma.

In similar fashion, the teenager needs to be able to establish the fact of their separate mind to their parents, even if only through a sustained state of cold rejection; and again unresolved adolescent issues can lead to a mechanical counterdependence and unruly assertiveness in later life.

Melancholia (from , '), also lugubriousness, from the Latin "lugere", to mourn; moroseness, from the Latin "morosus", self-willed, fastidious habit; wistfulness, from old English "wist": intent, or saturnine, was a concept in ancient and pre-modern medicine. Melancholy was one of the four temperaments matching the four humours. In the 19th century, "melancholia" could be physical as well as mental, and melancholic conditions were classified as such by their common cause rather than by their properties.

Mental retardation is coded on Axis II of the DSM-IV-TR. The diagnostic criteria necessary in order to diagnose intellectual disability consists of:

There are varying degrees of intellectual disability, which are identified by an IQ test.

Mental retardation, Severity Unspecified: This unspecified diagnosis is given when there is a strong assumption that the child is mentally retarded, but cannot be tested because the individual is too impaired, not willing to take the IQ test or is an infant.

Emotional detachment, in psychology, can mean two different things.

Emotional detachment can be a positive behavior which allows a person to react calmly to highly emotional circumstances/ individuals. Emotional detachment in this sense is a decision to avoid engaging emotional connections, rather than an inability or difficulty in doing so, typically for personal, social, or other reasons. In this sense it can allow people to maintain boundaries, psychic integrity and avoid undesired impact by or upon others, related to emotional demands. As such it is a deliberate mental attitude which avoids engaging the emotions of others.

This detachment does not necessarily mean avoiding empathy; rather it allows the person space needed to rationally choose whether or not to be overwhelmed or manipulated by such feelings. Examples where this is used in a positive sense might include emotional boundary management, where a person avoids emotional levels of engagement related to people who are in some way emotionally overly demanding, such as difficult co-workers or relatives, or is adopted to aid the person in helping others such as a person who trains himself to ignore the "pleading" food requests of a dieting spouse, or indifference by parents towards a child's begging.

Emotional detachment can also be used to describe what is often considered "emotional numbing", "emotional blunting", i.e., dissociation, depersonalization or in its chronic form depersonalization disorder. This type of emotional numbing or blunting is a disconnection from emotion, it is frequently used as a coping/ survival skill during traumatic childhood events such as abuse or severe neglect. Over time and with much use, this can become second nature when dealing with day to day stressors.

Emotional detachment often arises from psychological trauma and is a component in many anxiety and stress disorders. The person, while physically present, moves elsewhere in the mind, and in a sense is "not entirely present", making them sometimes appear preoccupied.

Thus, such detachment is often not as outwardly obvious as other psychiatric symptoms; people with this problem often have emotional systems that are in overdrive. They may have a hard time being a loving family member. They may avoid activities, places, and people associated with any traumatic events they have experienced. The dissociation can also lead to lack of attention and, hence, to memory problems and in extreme cases, amnesia.

A fictional description of the experience of emotional detachment experienced with dissociation and depersonalization was given by Virginia Woolf in "Mrs Dalloway". In that novel the multifaceted sufferings of a war veteran, Septimus Warren Smith, with post-traumatic stress disorder (as this condition was later named) including dissociation, are elaborated in detail. One clinician has called some passages from the novel "classic" portrayals of the symptoms.

There may be more than one reason to account for emotional detachment.

It is known that SSRI (selective serotonin reuptake inhibitor) antidepressants, after taken for a while or taken one after another (if the doctor is trying to see what works), can cause what is called "emotional blunting". In this instance, the individual in question is often unable to cry, even if he or she wants to.

In other cases, the person may seem fully present but operate merely intellectually when emotional connection would be appropriate. This may present an extreme difficulty in giving or receiving empathy and can be related to the spectrum of narcissistic personality disorder.

Emotional detachment also allows acts of extreme cruelty, such as torture and abuse, supported by the decision to not connect empathically with the person concerned. Social ostracism, such as shunning and parental alienation, are other examples where decisions to shut out a person creates a psychological trauma for the shunned party.

Considering these different definitions, the decision as to whether emotional detachment in any given set of circumstances is considered to be a positive or negative mental attitude is a subjective one, and therefore a decision on which different people may not agree.

PRS symptoms have common characteristics with many other psychiatric disorders. However, none of the present DSM diagnoses can account for the full scope of symptoms seen in PRS, and refusal to eat, weight loss, social withdrawal and school refusal can be considered as the main distinctive features. Any system may be involved, however some more commonly engaged than others.

Gastrointestinal:

- recurring pain

- nausea

- loss of appetite

Neurological:

- headache

- seizure

- motor dysfunction

- sensory dysfunction

- fatigue

- altered consciousness

Musculoskeletal:

- joint pains

- muscle weakness

Diogenes syndrome is a disorder that involves hoarding of rubbish and severe self-neglect. In addition, the syndrome is characterized by domestic squalor, syllogomania, social alienation, and refusal of help. It has been shown that the syndrome is caused as a reaction to stress that was experienced by the patient. The time span in which the syndrome develops is undefined, though it is most accurately distinguished as a reaction to stress that occurs late in life.

In most instances, patients were observed to have an abnormal possessiveness and patterns of compilation in a disordered manner. These symptoms suggest damages on the prefrontal areas of the brain, due to its relation to decision making. Although in contrast, there have been some cases where the hoarded objects were arranged in a methodical manner, which may suggest a cause other than brain damage.

Although most patients have been observed to come from homes with poor conditions, and many had been faced with poverty for a long period of time, these similarities are not considered as a definite cause to the syndrome. Research showed that some of the participants with the condition had solid family backgrounds as well successful professional lives. Half of the patients were of higher intelligence level. This indicates the "Diogenes syndrome" does not exclusively affect those experiencing poverty or those who had traumatic childhood experiences.

The severe neglect that they bring on themselves usually results in physical collapse or mental breakdown. Most individuals who suffer from the syndrome do not get identified until they face this stage of collapse, due to their predilection to refuse help from others.

The patients are generally highly intelligent, and the personality traits that can be seen frequently in patients diagnosed with Diogenes syndrome are aggressiveness, stubbornness, suspicion of others, unpredictable mood swings, emotional instability and deformed perception of reality. Secondary DS is related to mental disorders. The direct relation of the patients' personalities to the syndrome is unclear, though the similarities in character suggest potential avenues for investigation.

Diogenes syndrome, also known as senile squalor syndrome, is a disorder characterized by extreme self-neglect, domestic squalor, social withdrawal, apathy, compulsive hoarding of garbage or animals, and lack of shame. Sufferers may also display symptoms of catatonia.

The condition was first recognized in 1966 and designated Diogenes syndrome by Clark et al. The name derives from Diogenes of Sinope, an ancient Greek philosopher, a Cynic and an ultimate minimalist, who allegedly lived in a large jar in Athens. Not only did he not hoard, but he actually sought human company by venturing daily to the Agora. Therefore, this eponym is considered to be a misnomer, but he is actually a representative existence of self-neglect. Other possible terms are "senile breakdown", "Plyushkin's Syndrome" (after a character from Gogol's novel "Dead Souls"), "social breakdown" and "senile squalor syndrome". Frontal lobe impairment may play a part in the causation (Orrell et al., 1989).

There are no specific criteria for "externalizing behavior" or "externalizing disorders." Thus, there is no clear classification of what constitutes an externalizing disorder in the DSM-5. Attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), conduct disorder (CD), antisocial personality disorder(ASPD), pyromania, kleptomania, intermittent explosive disorder (IED), and substance-related disorders are frequently referred to as externalizing disorders. Disruptive mood dysregulation disorder has also been posited as an externalizing disorder, but little research has examined and validated it to date given its recent addition to the DSM-5, and thus, it is not included further herein.

Thompson and Nunn were the first to introduce diagnostic criteria for PRS in 1997. The current diagnostic criteria consists of:

- A) Partial or complete refusal in three or more of the following areas: (1) eating, (2) moving, (3) speech, (4) interest to personal care

- B) Active and angry resistance to acts of help and support

- C) Social withdrawal and school refusal

- D) No organic condition accounts for the severity of the degree of symptoms

- E) No other psychiatric disorder could better account for the symptoms

- F) The endangered state of the patient requires hospitalization

Inattention ADHD symptoms include: "often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or during other activities," "often has difficulty sustaining attention in tasks or play activities," "often does not seem to listen when spoken to directly," "often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace," "often has difficulty organizing tasks and activities," "often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort," "often loses things necessary for tasks or activities," "is often easily distracted by extraneous stimuli (for older adolescents and adults, may include unrelated thoughts)," and "is often forgetful in daily activities."

Hyperactivity and impulsivity ADHD symptoms include: "often fidgets with or taps hands or feet or squirms in seat," "often leaves seat in situations when remaining seated is expected," "often runs about or climbs in situations where it is inappropriate," "is often unable to play or engage in leisure activities quietly," "is often "on the go," acting as if "driven by a motor," "often talks excessively," "often blurts out an answer before a question has been completed," "often has difficulty waiting his or her turn," and "often interrupts or intrudes on others."

In order to meet criteria for an ADHD diagnosis, an individual must have at least 6 symptoms of inattention and/or hyperactivity/impulsivity, have an onset of several symptoms prior to age 12 years, have symptoms present in at least 2 settings, have functional impairment, and have symptoms that are not better explained by another mental disorder.

Mental disorders diagnosed in childhood are divided into two categories: childhood disorders and learning disorders. These disorders are usually first diagnosed in infancy, childhood, or adolescence, as laid out in the DSM IV TR and in the ICD-10. The DSM-IV-TR includes ten subcategories of disorders including Mental retardation, Learning Disorders, Motor Skills Disorders, Communication Disorders, Pervasive Developmental Disorders, Attention-Deficit and Disruptive Behavior Disorders, Feeding and Eating Disorders, Tic Disorders, Elimination Disorders, and Other Disorders of Infancy, Childhood, or Adolescence.

International Statistical Classification of Diseases and Related Health Problems, mostly known as "ICD", assigns codes to classify diseases, symptoms, complaints, social behaviors, injuries, and such medical-related findings.

ICD 10 classifies adjustment disorders under F40-F48 and under neurotic, stress-related and somatoform disorders.

An adjustment disorder (AD)—sometimes called exogenous, reactive, or situational depression—occurs when an individual is unable to adjust to or cope with a particular stress or a major life event. Since people with this disorder normally have symptoms that depressed people do, such as general loss of interest, feelings of hopelessness and crying, this disorder is sometimes known as situational depression. Unlike major depression, the disorder is caused by an outside stressor and generally resolves once the individual is able to adapt to the situation. One hypothesis about AD is that it may represent a sub-threshold clinical syndrome.

The condition is different from anxiety disorder, which lacks the presence of a stressor, or post-traumatic stress disorder and acute stress disorder, which usually are associated with a more intense stressor.

Common characteristics of AD include mild depressive symptoms, anxiety symptoms, and traumatic stress symptoms or a combination of the three. There are nine types of AD listed in the DSM-III-R. According to the DSM-IV-TR, there are six types of AD, which are characterized by the following predominant symptoms: depressed mood, anxiety, mixed depression and anxiety, disturbance of conduct, mixed disturbance of emotions and conduct, and unspecified. However, the criteria for these symptoms are not specified in greater detail. AD may be acute or chronic, depending on whether it lasts more or less than six months. According to the DSM-IV-TR, if the AD lasts less than 6 months, then it may be considered acute. If it lasts more than six months, it may be considered chronic. Moreover, the symptoms cannot last longer than six months after the stressor(s), or its consequences, have terminated. Diagnosis of AD is quite common; there is an estimated incidence of 5%–21% among psychiatric consultation services for adults. Adult women are diagnosed twice as often as are adult men. Among children and adolescents, girls and boys are equally likely to receive this diagnosis. AD was introduced into the psychiatric classification systems almost 30 years ago, but similar syndromes were recognized for many years before that.