PAS is
fueled by parental alienation, a series of behaviors used by an alienating parent, either consciously or subconsciously, to sully a child's relationship with the target parent.
In addition to the lack of assessment tools for identifying PAS or
parental alienation, therapists might have difficulty dealing with or identifying it due to concerns about the controversy surrounding it as a diagnosis, which is
fueled by the fact that is has not yet been accepted into the American Psychiatric Association's Diagnostic and Statistical Manual (DSM).