Psychiatric diagnostic classification system based on new forms of parenting practices: Narrative review and invite for a rethink

Abstract

New styles of parenting, such as hyper, hypo, atypical, and indifferent, have replaced the permissive, authoritarian, authoritarian, and neglectful styles of parenting that characterized child-adolescence psychology in the 1970s and 1980s. New parenting practices such as co-parenting, attachment parenting, positive parenting, LGBTQ parenting, free-range parenting, increased father involvement to support gender equality, and increased use of Assisted Reproductive Technologies, mums-net parenting, and intentional single-mother families, donor-conception, surrogacy, and families with trans-parents have changed the parenting landscape dramatically in recent years. Advances in artificial intelligence, machine learning, genetic testing, and brain imaging are expected to bring about further changes in parenting practices. A rethink of the prevailing child-adolescent psychiatric diagnostic classification system may be called for because it challenges traditional notions of what constitutes "normal" or "healthy" parenting. Researchers and clinicians may need to reconsider how they define and diagnose disordered conditions in light of these changing parenting practices. Parents may have to be moved out of their present position as observers, reporters, and even treatment agents. This evidence-gathering narrative review aims to initiate the idea that parents should be made the focus of a diagnostic classification system as well as treatment instead of children. Overall, the proposed branch of parent and carer psychiatry—where parents, not their children, are made the focus of diagnostic categories—if it happens, would embarrass the rank and file of child and adolescent psychiatry.