The American Professional Society on the Abuse of Children (APSAC) invited public comments regarding their proposal for a new diagnostic label of “child psychological maltreatment” (CPM), entitled: Prospective APSAC Practice Guidelines 2024 Revision For The Investigation And Determination Of Suspected Psychological Maltreatment Of Children And Adolescents.
My Public Comments to the APSAC proposed new pathology label of “child psychological maltreatment” (CPM) are posted to my Consulting Website – and were provided by link to the APSAC Comment page.
Click to access APSAC-Public-Comment-by-Dr.-Childress.pdf
The APSAC is proposing a new diagnostic label of “child psychological maltreatment” (CPM) that does not exist in any diagnostic system.
In formulating their new diagnostic label of “child psychological maltreatment” (CPM), the authors did not rely on the established scientific and professional knowledge of the DSM-5 & ICD-11 diagnostic systems which already contain a diagnosis of Child Psychological Abuse (V995.51), in seeming violation of Standard 2.04 Bases for Scientific and Professional Judgments of the American Psychological Association ethics code.
2.04 Bases for Scientific and Professional Judgments
Psychologists’ work is based upon established scientific and professional knowledge of the discipline.
The DSM-5 and ICD-11 diagnostic systems represent the “established scientific and professional knowledge of the discipline” that should be applied as the bases for professional diagnostic judgments. But instead of relying on the established scientific and professional knowledge provided by the DSM-5 and ICD-11 diagnostic systems, the APSAC is proposing a new pathology label called “child psychological maltreatment” (CPM) with diagnostic domains identified based on the opinions of the authors.
No offer is made by the authors as to why the DSM-5 diagnostic definition of child psychological abuse (V995.51) is inadequate and requires the proposed extensions into the new domains by the APSAC new diagnostic label of “child psychological maltreatment” (CPM)
The APSAC proposal for a new pathology label of “child psychological maltreatment” (CPM) is based on the proposal of three advisors to APSAC, Drs. Slep, Glasser, & Manly (2022).
From APSAC Guidelines: “The overarching definition and subtypes of CPM formulated and operationalized by Slep et al. [17], which include decision-making guides, are adopted in these APSAC Guidelines and presented in Figure 1 for application by professionals evaluating children to determine whether they have or have not been victims of psychological maltreatment..”
From APSAC Guidelines: “These guidelines are the product of APSAC’s Task Force on Psychological Maltreatment, co-chaired by Stuart N. Hart, PhD, and Marla Brassard, PhD. Contributions toward its development have been provided by… Danya Glaser, MD, Jody Todd Manly, PhD, and Amy M. Smith Slep, PhD.”
The APSAC proposal for a new pathology label of “child psychological maltreatment” (CPM) combines definitions found in the existing DSM-5 diagnosis of child psychological abuse (V995.51) with new domains from the personal opinions of the authors. No research support is offered by the authors for the extended definitions contained in their new diagnostic label of “child psychological maltreatment” (CPM).
Prominent professional concerns are present that the diagnostic criteria for a new pathology label by the APSAC called “child psychological maltreatment” (CPM) are culturally biased and are prone to misdiagnosis.
In their article, Slep, Glaser, and Manly (2022) indicate that there is currently no research support for their proposed diagnostic label of “child psychological maltreatment” (CPM), and that clinical trials are still needed to determine the validity and usefulness of their proposed new diagnostic label.
From Slep, Glaser, & Manly (2022): “We discuss the need for field trials to establish the utility of the definition.”
Until the APSAC proposal for a new diagnostic label called “child psychological maltreatment” (CPM) is in the DSM-5/ICD-11 diagnostic systems, it does not exist as a professional-level diagnosis and should not be relied on for decision-making surrounding children and families.
The DSM-5 provides the following definition for V995.51 Child Psychological Abuse:
From DSM-5: “Child psychological abuse is nonaccidental verbal or symbolic acts by a child’s parent or caregiver that result, or have reasonable potential to result, in significant psychological harm to the child. (Physical and sexual abusive acts are not included in this category.) Examples of psychological abuse of a child include berating, disparaging, or humiliating the child, threatening the child, harming/abandoning – or indicating that the alleged offender will harm/abandon – people or things that the child cares about; confining the child (as by tying a child’s arms or legs together or binding a child to furniture or another object, or confining the child to a small enclosed area (e.g., a closet); egregious scapegoating of the child, coercing the child to inflict pain on himself or herself; and disciplining the child excessively (i.e., at an extremely high frequency or duration, even if not at a level of physical abuse) through physical or nonphysical means.”
Diagnostic formulations should be based on the established scientific and professional knowledge of the DSM-5/ICD-11 diagnostic systems pursuant to Standard 2.04 Bases for Scientific and Professional Judgments of the APA ethics code.
Craig Childress, Psy.D.
Clinical Psychlogist,
WA 61538481 – CA 18857
Dr. Childress Consulting 